BACKGROUND: A wide variety of interventions exists in physical therapy (PT), but knowledge about their use across different geographical regions is limited. This study investigated the use of PT interventions in people with multiple sclerosis (MS) across Europe. It aimed to determine whether regions differ in applying interventions, and explore whether factors other than regions play a role in their use. METHODS: In an online cross-sectional survey, 212 respondents from 115 European workplaces providing PT services to people with MS representing 26 countries (four European regions) participated. Cluster analysis, Pearson Chi-squared test and a Poisson regression model were used to analyze the data. RESULTS: Thirteen of 45 listed PT interventions were used by more than 75% of centers, while nine interventions were used by less than 25%. For 12 interventions, regions differed markedly in their use. Cluster analysis of centers identified four clusters similar in their intervention use. Cluster assignment did not fully align with regions. While center region was important, center size, number and gender of physical therapists working in the center, and time since qualification also played a role. Cluster analysis exploring the use of the interventions provided the basis for a categorization of PT interventions in line with their primary focus: 1. Physical activity (fitness/endurance/resistance) training; 2. Neuroproprioceptive "facilitation/inhibition"; 3. Motor/skill acquisition (individualized therapy led); 4. Technology based interventions. CONCLUSIONS: To our knowledge this is the first study that has explored this topic in MS. The results broaden our understanding of the different PT interventions used in MS, as well as the context of their use.

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

Department of Statistical Modelling Institute of Computer Science Czech Academy of Sciences and Faculty of Mathematics and Physics Charles University Czech Republic

Department of Statistical Modelling Institute of Computer Science Czech Academy of Sciences Czech Republic

Department of Statistics School of Social Work and the Center for Statistics and the Social Sciences University of Washington Seattle USA

Don Gnocchi Foundation IRCCS Milan Larice Lab Via Capecelatro 66 20148 Milan Italy

Don Gnocchi Foundation Larice Lab IRCCS Milan Via Capecelatro 66 20148 Milan Italy

Faculty Health and Human Sciences Plymouth University Devon PL68BH United Kingdom

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

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

Hasselt University Campus Diepenbeek REVAL BIOMED Biomedical Research Institute Faculty of Medicine and Life Sciences Hasselt University Hasselt Belgium

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

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

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

Neurology Neuroimmunology Department and Neurorehabilitation Unit Multiple Sclerosis Centre of Catalonia Pg Vall d'Hebron 119 129 08035 Barcelona Spain

Nevrologgruppen Oslo Lillegrensen 7 N 0159 Oslo Norway

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

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

Referral Center for Autonomic Nervous System Disorders Department of Neurology University of Zagreb School of Medicine University Hospital Center Zagreb 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

University of West Attica Athens 24 Mitrodorou street 10441 Ak Pratonos Athens Greece

References provided by Crossref.org

Quality of life and quality of education among physiotherapy students in Europe

COMIRESTROKE-A clinical study protocol for monitoring clinical effect and molecular biological readouts of COMprehensive Intensive REhabilitation program after STROKE: A four-arm parallel-group randomized double blinded controlled trial with a longitudinal design

The impact of the COVID-19 pandemic on physical therapy practice for people with multiple sclerosis: A multicenter survey study of the RIMS network

Real-World Goal Setting and Use of Outcome Measures According to the International Classification of Functioning, Disability and Health: A European Survey of Physical Therapy Practice in Multiple Sclerosis

Content and Delivery of Physical Therapy in Multiple Sclerosis across Europe: A Survey