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Title: The organisation of physiotherapy for people with multiple sclerosis across Europe: a multicentre questionnaire survey
Authors: Rasova, Kamila
Freeman, Jenny
Martinkova, Patricia
Pavlikova, Marketa
Cattaneo, Davide
Jonsdottir, Johanna
Henze, Thomas
BAERT, Ilse 
Van Asch, Paul
Santoyo, Carme
Smedal, Tori
Beiske, Antonie Giaever
Stachowiak, Malgorzata
Kovalewski, Mariusz
Nedeljkovic, Una
Bakalidou, Daphne
Alves Guerreiro, Jose Manuel
Nilsagard, Ylva
Dimitrova, Erieta Nikolikj
Habek, Mario
Armutlu, Kadriye
Donze, Cecile
Ross, Elaine
Ilie, Ana Maria
Martic, Andrej
Romberg, Anders
FEYS, Peter 
Issue Date: 2016
Abstract: Background: Understanding the organisational set-up of physiotherapy services across different countries is increasingly important as clinicians around the world use evidence to improve their practice. This also has to be taken into consideration when multi-centre international clinical trials are conducted. This survey aimed to systematically describe organisational aspects of physiotherapy services for people with multiple sclerosis (MS) across Europe. Methods: Representatives from 72 rehabilitation facilities within 23 European countries completed an online web-based questionnaire survey between 2013 and 2014. Countries were categorised according to four European regions (defined by United Nations Statistics). Similarities and differences between regions were examined. Results: Most participating centres specialized in rehabilitation (82 %) and neurology (60 %), with only 38 % specialising in MS. Of these, the Western based Specialist MS centres were predominately based on outpatient services (median MS inpatient ratio 0.14), whilst the Eastern based European services were mostly inpatient in nature (median MS inpatient ratio 0.5). In almost all participating countries, medical doctors - specialists in neurology (60 %) and in rehabilitation (64 %) - were responsible for referral to/prescription of physiotherapy. The most frequent reason for referral to/prescription of physiotherapy was the worsening of symptoms (78 % of centres). Physiotherapists were the most common members of the rehabilitation team; comprising 49 % of the team in Eastern countries compared to approximately 30 % in the rest of Europe. Teamwork was commonly adopted; 86 % of centres based in Western countries utilised the interdisciplinary model, whilst the multidisciplinary model was utilised in Eastern based countries (p = 0.046). Conclusion: This survey is the first to provide data about organisational aspects of physiotherapy for people with MS across Europe. Overall, care in key organisational aspects of service provision is broadly similar across regions, although some variations, for example the models of teamwork utilised, are apparent. Organisational framework specifics should be considered anytime a multi-centre study is conducted and results from such studies are applied.
Notes: [Rasova, Kamila] Charles Univ Prague, Fac Med 3, Dept Rehabil, Ruska 87, Prague 10000 10, Czech Republic. [Freeman, Jenny] Univ Plymouth, Fac Hlth & Human Sci, Playmouth PL6 8BH, England. [Martinkova, Patricia] Acad Sci Czech Republic, Inst Comp Sci, Vodarenskou Vezi 2, Prague 18207 8, Czech Republic. [Rasova, Kamila; Pavlikova, Marketa] Charles Univ Prague, Fac Med 3, Ruska 87, Prague 10000 10, Czech Republic. [Cattaneo, Davide] Fdn Don C Gnocchi, Larice Lab, Via Capecelatro 66, I-20148 Milan, Italy. [Jonsdottir, Johanna] Fdn Don C Gnocchi, Larice Lab, Neurorehabil, Via Capecelatro 66, I-20148 Milan, Italy. [Henze, Thomas] PASSAUER WOLF Reha Zentrum Nittenau, Rehabil Klin Neurol Geriatrie Urol, Eichendorffstr 21, D-93149 Nittenau, Germany. [Baert, Ilse; Feys, Peter] Hasselt Univ, REVAL Rehabil Res Inst BIOMED, Campus Diepenbeek,Agoralaan Bldg A, B-3590 Diepenbeek, Belgium. [Van Asch, Paul] Fit Up Fitness & Physiotherapy Ctr, Mechelsesteen Weg 192a, B-2550 Kontich, Belgium. [Santoyo, Carme] Cemcat, Neurorehabil Unit, Passeig Vall dHebron 119-129, Barcelona 08035, Spain. [Smedal, Tori] Haukeland Hosp, Norwegian Multiple Sclerosis Competence Ctr, Dept Neurol, POB 1400, N-5021 Bergen, Norway. [Smedal, Tori] Haukeland Hosp, Dept Physiotherapy, POB 1400, N-5021 Bergen, Norway. [Beiske, Antonie Giaever] MS Senteret Hakadal AS, Blomsterbakken 33, N-1487 Hakadal, Norway. [Stachowiak, Malgorzata; Kovalewski, Mariusz] MS Rehabil Ctr, Szpitalna 5, PL-78449 Borne Sulinowo, Poland. [Nedeljkovic, Una] Clin Ctr Serbia, Clin Phys Med & Rehabil, Pasterova 2, Belgrade 11000, Serbia. [Bakalidou, Daphne] Technol Educ Inst Athens, 24 Mitrodorou St, Athens 10441, Greece. [Alves Guerreiro, Jose Manuel] Polytech Inst Leiria, Hlth Res Unit, Sch Hlth Sci, Campus 2, P-2411901 Leiria, Portugal. [Nilsagard, Ylva] Orebro Univ Reg, Fac Med & Hlth, SE-70182 Orebro, Sweden. [Dimitrova, Erieta Nikolikj] Ss Cyril & Methodius Univ, Fac Med, Inst Phys Med & Rehabil, Elisie Popovski 28, Skopje 1000, Macedonia. [Habek, Mario] Zagreb Sch Med, Dept Neurol, Referral Ctr Demyelinating Dis Cent Nervous Syst, Kispaticeva 12, HR-10000 Zagreb, Croatia. [Habek, Mario] Univ Hosp Ctr, Kispaticeva 12, HR-10000 Zagreb, Croatia. [Armutlu, Kadriye] Hacettepe Univ, Phys Therapy & Rehabil Dept, Fac Hlth Sci, Ankara, Turkey. [Donze, Cecile] Univ Nord France, Grp Hosp, Inst Catholique Lille, Dept Phys Med & Rehabil,Hosp St Philibert,Fac Lib, F-59000 Lille, France. [Ross, Elaine] St James Hosp, St Jamess St, Dublin 8, Ireland. [Ilie, Ana Maria] Elias Univ Emergency Hosp, 17 Marasti Blvd, Bucharest 01146, Romania. [Martic, Andrej] Univ Med Ctr Ljubljana, Neurorehabil Unit, Divison Neurol, Zaloska 2, Ljubljana 1000, Slovenia. [Romberg, Anders] Masku Neurol Rehabil Ctr, Physiotherapy, Vaihemaentie 10,POB 15, Masku 21251, Finland.
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e-ISSN: 1472-6963
DOI: 10.1186/s12913-016-1750-6
ISI #: 000384937100001
Rights: © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Category: A1
Type: Journal Contribution
Validations: ecoom 2017
Appears in Collections:Research publications

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