Perceived value of physiotherapy and occupational therapy among people with multiple sclerosis: insights from a...

While physiotherapy, occupational therapy and Cesar/Mensendieck exercise therapy are considered essential in the management of multiple sclerosis (MS), little is known about how people with MS (PwMS) value these therapies across the disease course. This study explores the lived experiences and values of PwMS regarding these therapies during the lifespan with MS.

In-depth interviews were conducted with a purposive sample of 23 PwMS (15 females, 8 males; median age 50 years, range 32-79; median disease duration 13 years, range 2-32). The sample size ensured a broad range of experiences with the therapies, so that in-depth and detailed meanings could be obtained for interpretative phenomenological analysis, coloured by contextual factors.

PwMS highly value continuous physiotherapy and occupational therapy, especially when tailored to personal needs and disease progression. Only 7 PwMS had experiences with Cesar/Mensendieck therapy. Five key themes emerged: values related to the patient, the therapist, the patient-therapist relationship, the therapy itself, and collaboration among healthcare providers. These values are dynamic, multifaceted and interwoven, underpinning positive therapy experiences. Personal needs, goals, and the role of the therapist evolve over time, and therapies shift from general orientation to tailored interventions, empowering PwMS to make increasingly autonomous and confident decisions.

Continuous, individualized physiotherapy and occupational therapy are highly valued by PwMS. Adapting therapy to their interwoven values, evolving needs and circumstances, is considered essential for optimal MS care.