What do you mean, you want physiotherapy?

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Elaine Toomey and Dr. Susan Coote. Department of Physiotherapy. University of Limerick. Results. B2 “I didn't have any physiotherapy at all until the Getting the ...

“What do you mean, you want physiotherapy?” A Focus Group Study of Perceptions of Physiotherapy in Multiple Sclerosis Patients Who Use a Walking Aid Elaine Toomey and Dr. Susan Coote Department of Physiotherapy. University of Limerick

Introduction In 2006, a Lansdowne market research survey found that physiotherapy was listed as a top priority by people with Multiple Sclerosis (PwMS). Studies also show that the majority of PwMS who present for physiotherapy have walking difficulties and use walking aids (Coote et al. 2010). However, it remains unknown what PwMS perceive as ‘physiotherapy’ and what they actually want by requesting it, as no studies have appeared to address this question.



A central theme highlighted participants’ perceptions and expectations of physiotherapy as physical activity: “Physiotherapy now is just general exercising every, all parts of the body, exercise and keeping...the balance...right” (A1), a view formed by their Experience of Physiotherapy: A2 “I have to say, I love the thing of other people being there....Because exercising on your own is very boring.”

B2 “It has been very beneficial, and you do feel much better and certainly more supple, having done the hour of physiotherapy.”

Benefits of Physiotherapy ++

A2 “Well you do, you need somebody there kinda give you an aul’ nudge and telling you ‘go on, get on and do some more’.”

To explore the perceptions that PwMS who use walking aids have of physiotherapy and to gain an understanding of what they mean when they request physiotherapy services.



Methods Study Design: •Qualitative focus group methodology

Participants: •8 PwMS using walking aids •Recruited through Mid-West Regional Office of MS Society

Data Collection: •Questioning route formulated and piloted •Two audio-recorded focus groups conducted (3 and 5 PwMS respectively) •Notes on group dynamics taken by assistant moderator

Data Analysis: •Recordings transcribed verbatim •Theoretical thematic analysis to identify themes •Member checking to confirm themes Ethical approval and informed consent were obtained for this study

B4 “I feel I need it as well. Like that I enjoy coming to the classes, coz you’re in a group and I feel I’m doing something myself. But in a humorous way, you know, enjoying it”

+ +

Relationship with Physiotherapist

Challenges of Physiotherapy B2 “I didn’t have any physiotherapy at all until the Getting the Balance Right [physiotherapy programme]came into vogue.” +, ++, +++ indicates relative weighting of themes

B3 “I think with that, you’re not in an exercise situation, you’re at home. Home to me...it’s not...part of your life.”

B1 “I think they [physiotherapists] are excellent”

B2 “There was one of the physios there, following you around the whole time, making sure that you did it, and that you did it correctly. And it was fantastic”


PwMS perceive physiotherapy as predominantly physical activity. Though they report many benefits from it, they also describe difficulties staying physically active in the absence of a physiotherapist and as a result are concerned about decreasing services. As PwMS want and expect physiotherapy to keep them active, physiotherapists should therefore play a role in enabling PwMS to self-manage their condition and maintain their own activity levels. Further studies are recommended to explore the role of the physiotherapist in MS self-management, and also the perceived barriers and facilitators to self-management in MS. References: Coote, S., McKeown, G. and Shannon, M. (2010) ‘Which People With MS Access Physiotherapy Services, and How Much Treatment Do They Receive? A Survey in Ireland’, in Selzer, M.E. and Binder, H., chairs, Proceedings of 6th World Congress of NeuroRehabilitation, Vienna, Austria , 21-25 Mar, p150.