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.

3rd Faculty of Medicine Charles University Prague Ruska 87 Prague 10 100 00 Czech Republic

Cemcat Neurorehabilitation Unit Passeig de la Vall d'Hebron 119 129 08035 Barcelona Spain

Clinic for physical medicine and rehabilitation Clinical Center of Serbia Pasterova 2 11000 Belgrade Serbia

Department of Neurology Norwegian Multiple Sclerosis Competence Centre Haukeland University Hospital P O Box 1400 5021 Bergen Norway

Department of Physiotherapy Haukeland University Hospital P O Box 1400 5021 Bergen Norway

Department of rehabilitation 3rd Faculty of Medicine Charles University Prague Ruska 87 Prague 10 100 00 Czech Republic

Divison of Neurology Neurorehabilitation unit University Medical Centre Ljubljana Zaloška 2 1000 Ljubljana Slovenia

Don Gnocchi Foundation Larice Lab Santa Maria Nascente Via Capecelatro 66 20148 Milan Italy

Elias University Emergency Hospital 17 Marasti Bulevard Bucharest 01146 Romania

Faculty of Health and Human Science Plymouth University Playmouth PL6 8BH England

Faculty of Medicine and Health Örebro University Region SE 701 82 Örebro Sweden

Fit Up Fitness and Physiotherapy Center Mechelsesteen weg 192a 2550 Kontich Belgium

Groupe Hospitalier de l'institut Catholique de Lille Department of physical Medicine and Rehabilitation hospital Saint Philibert Faculté Libre de Médecine Univ Nord de France F 59000 Lille France

Hasselt University Campus Diepenbeek REVAL Rehabilitation Research Institute Agoralaan building A B 3590 Diepenbeek Belgium

Institute of Computer Science Academy of Sciences of the Czech Republic Pod Vodarenskou vezi 2 Prague 8 182 07 Czech Republic

Institute of Physical Medicine and Rehabilitation Faculty of Medicine Ss Cyril and Methodius University Elisie Popovski 28 1000 Skopje Macedonia Republic of The former Yugoslav

Masku Neurological Rehabilitation Centre Physiotherapy Vaihemäentie 10 PO Box 15 21251 Masku Finland

MS Rehabilitation Centre Szpitalna 5 78 449 Borne Sulinowo Poland

MS Senteret Hakadal AS Blomsterbakken 33 1487 Hakadal Norway

Neurorehabilitation at the Don Gnocchi Foundation Larice Lab Santa Maria Nascente Via Capecelatro 66 20148 Milan Italy

PASSAUER WOLF Reha Zentrum Nittenau Rehabilitations klinik für Neurologie Geriatrie Urologie Eichendorffstr 21 D 93149 Nittenau Germany

Physical Therapy and Rehabilitation departmant of Health Science Faculty Hacettepe University Ankara Turkey

Referral Center for Demyelinating Diseases of the Central Nervous System University Department of Neurology Zagreb School of Medicine and University Hospital Center Kispaticeva 12 HR 10000 Zagreb Croatia

School of Health Sciences Health Research Unit Polytechnic Institute of Leiria Campus 2 Morro do Lena Alto do Vieiro 2411 901 Leiria Portugal

St James's Hospital St James's street Dublin 8 Ireland

Technological Educational Institute of Athens 24 Mitrodorou street Ak Pratonos 10441 Athens Greece

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