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Physiotherapy use and access-barriers in persons with multiple sclerosis: A cross-sectional analysis
Remo Fortunato1, Nico Arie van der Maas2, Ursula Biland-Thommen3
1Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland; Department of Health Sciences and Technology, ETH Zurich, Zürich, Switzerland.
Multiple Sclerosis and Related Disorders
|December 28, 2020
Summary
Physiotherapy access for multiple sclerosis (MS) patients is not significantly limited by socio-demographic factors. However, uptake is higher in those with more severe MS symptoms and recent rehabilitation stays.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Public Health
Background:
- Physiotherapy is recognized for its potential to alleviate multiple sclerosis (MS) symptoms.
- Limited understanding exists regarding physiotherapy accessibility and associated barriers for persons with MS (pwMS).
- This study investigates physiotherapy utilization and access barriers in a large MS cohort.
Purpose of the Study:
- To determine factors influencing physiotherapy use in persons with MS (pwMS).
- To identify potential barriers to accessing physiotherapy services for pwMS.
- To analyze the relationship between MS severity, quality of life, and physiotherapy uptake.
Main Methods:
- Utilized data from 1493 pwMS in the Swiss Multiple Sclerosis Registry (SMSR).
- Employed multivariable logistic regression to analyze physiotherapy use (yes/no).
- Incorporated socio-demographic, health status, and mobility variables, with missing data handled via multiple imputation.
Main Results:
- Physiotherapy use positively correlated with progressive MS, higher impairment (EDSS 4-6.5), increased symptom count, disability pension status, gait problems, recent rehabilitation, and current disease-modifying treatment.
- Negative associations observed with higher quality of life, extensive work hours (>80%), and residing in the French-speaking region.
- No significant association found between physiotherapist supply and regular physiotherapy use.
Conclusions:
- Socio-demographic factors appear to present minimal barriers to physiotherapy access for pwMS in Switzerland.
- Physiotherapy uptake is notably higher in individuals with greater MS-related impairments and lower quality of life.
- Observed regional differences in uptake necessitate further investigation.
