HANDS-ON PHYSIOTHERAPY: A TOOL FOR DEVELOPMENT OF PRACTICE AND KNOWLEDGE IN NEUROMUSCULAR DISEASES

¹University Hospital of Northern Norway, National Neuromuscular Centre, Tromsø, Norway

Background: At the National Neuromuscular Centre Norway (NMK), the physiotherapy team consists of three persons. All are specialized in neurological physiotherapy, and are an integral part of a multidisciplinary team. The PTs are involved in diagnosing and providing treatment to patients with rare hereditary neuromuscular diseases, as well as arranging clinical courses and giving individual guidance to PTs in the communities. The foundation for clinical guidance and the development of clinical courses at NMK, lies within evidence-based practice. However, there are few and small studies in the neuromuscular population, and studies of physiotherapy practice are lacking.

Purpose: The purpose of the special interest report is to highlight and discuss how clinical expertise may augment development of practice and physiotherapy knowledge in neuromuscular diseases.

Methods: Evidence-based knowledge from patients with CNS-pathology, is employed as a foundation and framework for individual assessment and treatment for neuromuscular patients. At NMK, the PTs weekly meet patients for a 3-4 hour assessment. 6 times a year, three patients come for a bout of intensive individual physiotherapy lasting 90 minutes a day for two weeks. The PTs thus regularly encounter patients with rare neuromuscular diseases in clinical practice.

Results: Hands-on physiotherapy combined with in-depth movement analyses are seen as powerful tools in patient encounters and treatment of the individual. Such approaches are used to explore available movement resources with optimization of movement strategies based on knowledge of the underlying disease. Through regular hands-on practice with the patient group, clinical expertise, known to be an integral principle of evidence-based medicine, is developed and enhanced.

Conclusion(s): Clinical expertise developed through regular hands-on experience is a prerequisite to enhance the evidence base and guide clinical physiotherapy practice for patients with rare hereditary neuromuscular diseases, as research knowledge currently is lacking within the field.

Implications: - Clinical expertise is of utmost importance as part of the trinity in evidence-based physiotherapy, as there currently are no available studies for most of the neuromuscular diseases - Physiotherapists should integrate hands-on interventions as a tool in clinical practice for the patient group - Qualitative and quantitative studies are needed to elaborate experiences with hands-on physiotherapy and explore its effectiveness in populations with rare neuromuscular diseases.

Funding acknowledgements: This work was unfunded.

Topic: Neurology

Ethics approval: Ethics approval was not required.

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