title: Access, delivery and perceived efficacy of physiotherapy and use of complementary and alternative therapies by people with progressive multiple sclerosis in the United Kingdom: An online survey.
abstract: BACKGROUND
  All people with progressive MS in the United Kingdom should have access to physiotherapy through the National Health Service (NHS). However levels of access and delivery are unknown. Furthermore there is no research on perceived efficacy of physiotherapy or the use of complementary and alternative medicine in people with progressive MS in the United Kingdom.
  
  
  METHODS
  An online survey was carried out via the UK MS Register. Inclusion criteria were diagnosis of progressive MS, a member of UK MS Register and 18 years or older. The survey asked participants regarding access and delivery of physiotherapy; perceived efficacy of physiotherapy and interventions received; barriers to accessing physiotherapy and use of complementary and alternative medicine. The following additional data were supplied from the UK MS Register: demographics, EQ5D, MSIS-29 physical and psychological sub-scales and geographical data.
  
  
  RESULTS
  Total number of respondents was 1,298 from an identified 2,538 potential registrants: 87% could access physiotherapy services, 77% received physiotherapy from the NHS and 32% were currently receiving physiotherapy. The most common interventions received were home exercise programme (86%), exercises with a physiotherapist (74%) and advice/education (67%). 40% had recently used complementary and alternative medicine. Perceived efficacy of physiotherapy was high with 70% reporting it to be either 'beneficial' or 'very beneficial'. Main barriers to accessing physiotherapy were mobility, fatigue, continence, transport issues, requiring someone to go with them and pain.
  
  
  CONCLUSIONS
  Access to physiotherapy was high with most people reporting it as beneficial. However 13% reported not having access indicating a gap in accessibility. Considering some of the barriers reported may allow physiotherapy services to address this gap in accessibility.
authors.affiliation: School of Medicine, The University of Glasgow, Glasgow, Scotland, UK. Electronic address: e.campbell.4@research.gla.ac.uk.
authors.forename: Evan
authors.initials: E
authors.lastname: Campbell
authors.affiliation: School of Medicine, The University of Glasgow, Glasgow, Scotland, UK. Electronic address: ECoulter@qmu.ac.uk.
authors.forename: Elaine
authors.initials: E
authors.lastname: Coulter
authors.affiliation: Multiple Sclerosis Service, NHS Ayrshire & Arran, Irvine, Scotland, UK. Electronic address: EFC_7@hotmail.com.
authors.forename: Paul
authors.initials: P
authors.lastname: Mattison
authors.affiliation: akm-stats, Glasgow, Scotland, UK. Electronic address: akm@akm-stats.com.
authors.forename: Angus
authors.initials: A
authors.lastname: McFadyen
authors.affiliation: Multiple Sclerosis Service, NHS Ayrshire & Arran, Irvine, Scotland, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK. Electronic address: linda.miller@gcu.ac.uk.
authors.forename: Linda
authors.initials: L
authors.lastname: Miller
authors.affiliation: School of Medicine, The University of Glasgow, Glasgow, Scotland, UK. Electronic address: Lorna.Paul@glasgow.ac.uk.
authors.forename: Lorna
authors.initials: L
authors.lastname: Paul
mesh_terms: D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010465:Perception; D026741:Physical Therapy Modalities / Q000523:psychology / Q000706:statistics & numerical data; D012042:Registries; D012424:Rural Population / Q000706:statistics & numerical data; D057566:Self Report; D014186:Transportation; D006113:United Kingdom / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Access; Complementary therapies; Physiotherapy; Progressive multiple sclerosis; Rehabilitation