Physiotherapists perceived role in managing anxiety in patients with Relapsing-Remitting Multiple Sclerosis: a mixed-methods study

Abstract

ABSTRACTObjectivesTo explore how physiotherapists manage anxiety in patients with RRMS in community and outpatient settings. To identify further training and research to better develop physiotherapy practice.DesignA mixed-methods design, combining a cross-sectional survey and semi-structured interviews with UK-physiotherapists.ParticipantsSixteen UK-registered physiotherapists: 11 in the survey, 5 in the interviews.MethodsTo inform the qualitative study, a cross-sectional survey collected data from physiotherapists working in neurology to understand the impact and management of anxiety in people with MS (PwMS) during rehabilitation. Analysis used descriptive statistics and the findings formed the interview guide. Semi-structured interviews with specialist physiotherapists explored barriers and facilitators to managing anxiety, physiotherapy training needs and offered suggestions to develop physiotherapy research and practice. Themes were derived inductively.ResultsThe survey suggested how PwMS present with anxiety, its impact during rehabilitation, physiotherapy management practices, and physiotherapist skills and training needs. Five semi-structured interviews with specialist physiotherapists expanded on the survey findings and identified five main themes: Understanding the MS journey, modifying assessment and treatment, anxiety management toolbox, lagging behind Musculoskeletal Physiotherapy, and gaining knowledge and skills.ConclusionPhysiotherapists encounter anxiety in PwMS in community and outpatient rehabilitation and perceive they have a role in managing it as it presents. Facilitators included communication, listening skills and opportunities to develop strong therapeutic relationships. Poor training and support, lack of clinical guidelines and limited research evidence were considered barriers. Clinically relevant learning opportunities, interprofessional working, and greater support through clinical supervision is recommended to better develop physiotherapy practice.Contribution of the paperKey messagesPhysiotherapists perceive they have a role in managing anxiety and psychological wellbeing in PwMS as it presents in community and outpatient neurorehabilitation settings.Opportunities to build strong therapeutic relationships through effective communication and listening skills are considered important in being able to manage patient anxiety effectively.Poor training and support and a lack of clinical guidelines continue to be barriers in this area.New knowledgeOnline CPD facilitated through the CSP website and iCSP learning platform may be beneficial to increase competence in this area.Further research to understand the MS illness experience in relation to rehabilitation is required to better inform physiotherapy practice and identify appropriate psychologically informed physiotherapy interventions.