Physiotherapy assessment of individuals with multiple sclerosis prior to a group intervention – A qualitative observational and interview study

ABSTRACT

Assessment prior to both individual and group interventions is fundamental to neurological physiotherapy practice. However, knowledge is limited regarding how assessments are carried out, particularly assessments conducted prior to group interventions, which have recently gained increasing attention in clinical research. In this qualitative study, we investigated how physiotherapy assessments of patients with multiple sclerosis prior to a group exercise intervention were carried out and what physiotherapists considered vital elements in the assessment process. Data were gathered through 12 qualitative non-participatory video observations followed by in-depth interviews of physiotherapists. Systematic text condensation analysis was conducted within an enactive theoretical framework of participatory sense making. In the assessments, patients’ bodily perceptions of movement changes appeared to be vital in establishing patient expectations for the forthcoming intervention. The extent of patient participation and an embodied approach to communication influenced both the physiotherapists’ and patients’ insights into the patients’ movement problems, which were further utilized in the initial intervention planning. Significant differences in context from the assessment to the intervention require a systematic completion of the assessments in the course of the first clinical meeting, which should be considered in the further development of research and clinical practices.

KEYWORDS:

• Assessment
• examination
• neurological physiotherapy
• multiple sclerosis
• group intervention
• interaction
• embodiment

Acknowledgments

We would like to express our deepest gratitude for the participating PTs’ and patients’ courageous and generous contributions toward making this study possible.

Declaration of Interest

The authors report no declaration of interest.

Notes

¹ Originally, the intervention was named GroupCoreSIT but was renamed GroupCoreDIST after further development and analysis of the RCT.

² EDSS – a widely used measure in clinical trials and the assessment of people with MS for quantifying disability and monitoring changes in disability over time. 1.0 – walking independently; 6.5 – able to walk 20 m with two crutches (Kurtzke, 1983).