Evaluating the Usefulness of two Physical Therapy Specialty Service Models for Individuals With Multiple Sclerosis in Rural Communities

Research Objectives: To determine the effectiveness of supporting rural physical therapists (PTs) with written Multiple Sclerosis (MS) specific treatment recommendations vs. virtual consultation on therapy outcomes.

Design: In this randomized control trial, MS neurologists identified and wrote PT orders for people with MS (pwMS). PwMS contacted a PT of their choice in their rural (1,2) community. PwMS and their PTs were randomly assigned to the control group, or 1 of 2 other conditions.

Setting: PwMS were enrolled during routine MS medical clinic appointments. PT service was provided in the clinic of their choice in their rural community. PT enrollment and consultations occurred virtually.

Participants: A random sample of 71 rural pwMS and their PTs were approached: 67 enrolled and 21 withdrew. PwMS with a definite MS diagnosis, 2017 McDonald Criteria (3), were enrolled. PTs self-reported limited or no MS experience per study defined criteria.

Interventions: PwMS received MS neurologist written PT orders and completed a PT assessment with the study team’s MS PT. The PT's in groups 2 and 3 received written PT treatment recommendations. The 3rd group also received virtual consultations with MS PT.

Main Outcome Measures: The rural PTs completed questionnaires comparing the effectiveness of orders vs written recommendations vs virtual consultations.

Results: While 67% of the PTs agreed or strongly agreed that the physician orders were helpful for planning the therapy program, 100% reported the same for the study PTs recommendations. Seventy-five percent strongly agreed or agreed that the virtual consultation was helpful.

Sixty-three percent of the PTs reported that the written recommendations had a positive impact on the outcome, and 75% reported the telehealth consultations did. Seventy-six percent of the PTs rated the impact of the orders on therapy outcome as neutral.

Conclusions: Rural PTs reported a positive patient outcome from input from a PT with MS expertise for the pwMS. It appears that the telehealth component adds additional benefit compared to specific recommendations alone.

Author(s) Disclosures: No author reports any relationship that would bias presentation findings.