QUESTIONNAIRE ON PHYSICAL REHABILITATION IN MULTIPLE SCLEROSIS DURING THE COVID PANDEMIC_PROFESSIONALS

QUESTIONNAIRE ON PHYSICAL REHABILITATION IN MULTIPLE SCLEROSIS DURING THE COVID PANDEMIC_PROFESSIONA

PURPOSE OF THE STUDY
As part of the mobility special interest group (SIG) of the ‘Rehabilitation in Multiple Sclerosis network’ (RIMS), we are undertaking this survey in order to determine how physical therapy services for people with MS (access, type of treatment, delivery mode, practical, etc) were affected by the COVID pandemic

WHAT WILL THE STUDY INVOLVE?
The study will involve a short survey on your experiences about the delivery of your physiotherapy practice both before the COVID pandemic and in current times. The study includes a mixture of both closed and open-ended questions, and should take approximately 15-20 minutes to complete.

WHO HAS APPROVED THE STUDY?
This study has been reviewed and received ethical approval from the central ethical committees. You may have a copy of this approval if you request it.

WHY HAVE YOU BEEN ASKED TO TAKE PART?
You have been asked to participate because you are a physiotherapist working with people with multiple sclerosis.

DO YOU HAVE TO TAKE PART?
No, you are under no obligation whatsoever to take part in this research. It is entirely up to you to decide whether or not you would like to take part. If you decide to do so, you will be asked to complete an electronic anonymized consent form. If you decide to take part, you are still free to withdraw at any time without giving a reason.

WHAT INFORMATION WILL BE COLLECTED?
Information on your age group, education, experience and organization would be requested. This is followed by questions concerning organizational changes and rehabilitation practices both prior to the COVID-19 pandemic and current times.

WILL YOUR INFORMATION BE KEPT CONFIDENTIAL?
Yes, all information that is collected about you during the course of the research will be kept confidential. The surveys are designed in such a way that you cannot be identified from the data that you provide, and therefore is completely anonymous.

WHAT WILL HAPPEN TO THE INFORMATION THAT YOU GAVE?
All the information you provide will be inputted in a digital database. This database will be kept with the primary investigator of the study. Additionally, this database will be shared with the coordinator of the SIG mobility of RIMS’s network in order to undergo analysis. The datasets will be destroyed within 10 years.

WHAT WILL HAPPEN TO THE RESULTS?
Once the data in the datasets are analyzed, the research will be written up and presented as a summary report to be discussed at RIMS SIG mobility group meetings, and may be published in scientific journals or presented at National or International Conferences. A copy of the research findings will be made available to you upon request to Dr Elaine Toomey.

WHAT ARE THE POSSIBLE CONSEQUENCES OF TAKING PART?
We do not envisage any negative consequences for you in taking part in this research.

ANY FURTHER QUESTIONS?
If you need any further information, you can contact Susan Coote SusanC@ms-society.ie

If you agree to take part in the study, please complete the consent form on the next page.

Thank you for taking the time to read this.

This research study has received Ethics approval from the Education and Health Sciences Research Ethics Committee 2021_03_09

If you have any concerns about this study and wish to contact someone independent you may contact the Chairman Education and Health Sciences Research Ethics Committee
EHS Faculty Office, University of Limerick
Tel (061) 234101
Email : ehsresearchethics@ul.ie

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* 1. Consent:
Please indicate your eligibility and consent to participant in the following research
- I am a physiotherapist and provide services to people with multiple sclerosis
- The purpose and nature of the study has been explained to me in writing
- I am participating voluntarily - I understand that I can withdraw from the study without repercussions at any time, whether that is before it starts or while I am participating.
- It has been explained to me how my data will be managed
- I understand that my data is confidential as described in the information sheet
- I understand that my data is collected anonymously, and that this anonymous dataset would be shared within the SIG mobility group of the RIMS network.
- I understand that my data may be used in further research projects and any subsequent publications

I agree to the above statements and consent to continue to the questionnaire

Yes

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* 2. What is your age

20-30

31-40

41-50

51-60

over 60

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* 3. What is your gender?

Male

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* 9. In what setting do you work?

Acute hospital/center

Rehabilitation Hospital/Center

Community Centre/Services

Private clinic/practice

Other (please specify)

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* 10. Type of treatment offered in your workplace

Inpatient

Outpatient

Both

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* 11. Were you infected by COVID?

Yes

Not sure/Not tested

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* 12. Usage of different PT methods in patients with MS DURING the Covid-19 pandemic
Please describe, how did Covid-19 affect the frequency and the kind of use of the following PT interventions DURING the pandemic (2020).

	Never or rarely used	Cannot use it now	Decreased use	No change	Increased use	Recently started using
Aerobic training, conditioning exercises	Aerobic training, conditioning exercises Never or rarely used	Aerobic training, conditioning exercises Cannot use it now	Aerobic training, conditioning exercises Decreased use	Aerobic training, conditioning exercises No change	Aerobic training, conditioning exercises Increased use	Aerobic training, conditioning exercises Recently started using
Strengthening, resistance training	Strengthening, resistance training Never or rarely used	Strengthening, resistance training Cannot use it now	Strengthening, resistance training Decreased use	Strengthening, resistance training No change	Strengthening, resistance training Increased use	Strengthening, resistance training Recently started using
Stretching	Stretching Never or rarely used	Stretching Cannot use it now	Stretching Decreased use	Stretching No change	Stretching Increased use	Stretching Recently started using
Relaxation techniques, yoga, tai chi	Relaxation techniques, yoga, tai chi Never or rarely used	Relaxation techniques, yoga, tai chi Cannot use it now	Relaxation techniques, yoga, tai chi Decreased use	Relaxation techniques, yoga, tai chi No change	Relaxation techniques, yoga, tai chi Increased use	Relaxation techniques, yoga, tai chi Recently started using
Classical PT procedures (Bobath, PNF, Perfetti, Frenkel, Petö, Rood)	Classical PT procedures (Bobath, PNF, Perfetti, Frenkel, Petö, Rood) Never or rarely used	Classical PT procedures (Bobath, PNF, Perfetti, Frenkel, Petö, Rood) Cannot use it now	Classical PT procedures (Bobath, PNF, Perfetti, Frenkel, Petö, Rood) Decreased use	Classical PT procedures (Bobath, PNF, Perfetti, Frenkel, Petö, Rood) No change	Classical PT procedures (Bobath, PNF, Perfetti, Frenkel, Petö, Rood) Increased use	Classical PT procedures (Bobath, PNF, Perfetti, Frenkel, Petö, Rood) Recently started using
Balance training (static, dynamic), postural awareness, trunk control	Balance training (static, dynamic), postural awareness, trunk control Never or rarely used	Balance training (static, dynamic), postural awareness, trunk control Cannot use it now	Balance training (static, dynamic), postural awareness, trunk control Decreased use	Balance training (static, dynamic), postural awareness, trunk control No change	Balance training (static, dynamic), postural awareness, trunk control Increased use	Balance training (static, dynamic), postural awareness, trunk control Recently started using
Balance platform (devices for proprioceptive posture therapy)	Balance platform (devices for proprioceptive posture therapy) Never or rarely used	Balance platform (devices for proprioceptive posture therapy) Cannot use it now	Balance platform (devices for proprioceptive posture therapy) Decreased use	Balance platform (devices for proprioceptive posture therapy) No change	Balance platform (devices for proprioceptive posture therapy) Increased use	Balance platform (devices for proprioceptive posture therapy) Recently started using
Dual Tasking	Dual Tasking Never or rarely used	Dual Tasking Cannot use it now	Dual Tasking Decreased use	Dual Tasking No change	Dual Tasking Increased use	Dual Tasking Recently started using
Orthotic devices assessment and training	Orthotic devices assessment and training Never or rarely used	Orthotic devices assessment and training Cannot use it now	Orthotic devices assessment and training Decreased use	Orthotic devices assessment and training No change	Orthotic devices assessment and training Increased use	Orthotic devices assessment and training Recently started using
Pelvic floor exercises	Pelvic floor exercises Never or rarely used	Pelvic floor exercises Cannot use it now	Pelvic floor exercises Decreased use	Pelvic floor exercises No change	Pelvic floor exercises Increased use	Pelvic floor exercises Recently started using
Conductive education programme	Conductive education programme Never or rarely used	Conductive education programme Cannot use it now	Conductive education programme Decreased use	Conductive education programme No change	Conductive education programme Increased use	Conductive education programme Recently started using
Constraint-Induced movement therapy	Constraint-Induced movement therapy Never or rarely used	Constraint-Induced movement therapy Cannot use it now	Constraint-Induced movement therapy Decreased use	Constraint-Induced movement therapy No change	Constraint-Induced movement therapy Increased use	Constraint-Induced movement therapy Recently started using
Training of activities of daily living	Training of activities of daily living Never or rarely used	Training of activities of daily living Cannot use it now	Training of activities of daily living Decreased use	Training of activities of daily living No change	Training of activities of daily living Increased use	Training of activities of daily living Recently started using

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* 13. cont...

	Never or rarely used	Cannot use it now	Decreased use	No change	Increased use	Recently started using
Fatigue management program	Fatigue management program Never or rarely used	Fatigue management program Cannot use it now	Fatigue management program Decreased use	Fatigue management program No change	Fatigue management program Increased use	Fatigue management program Recently started using
Treadmill training, body weight support walking training	Treadmill training, body weight support walking training Never or rarely used	Treadmill training, body weight support walking training Cannot use it now	Treadmill training, body weight support walking training Decreased use	Treadmill training, body weight support walking training No change	Treadmill training, body weight support walking training Increased use	Treadmill training, body weight support walking training Recently started using
Biofeedback, electrical stimulation	Biofeedback, electrical stimulation Never or rarely used	Biofeedback, electrical stimulation Cannot use it now	Biofeedback, electrical stimulation Decreased use	Biofeedback, electrical stimulation No change	Biofeedback, electrical stimulation Increased use	Biofeedback, electrical stimulation Recently started using
Hippotherapy	Hippotherapy Never or rarely used	Hippotherapy Cannot use it now	Hippotherapy Decreased use	Hippotherapy No change	Hippotherapy Increased use	Hippotherapy Recently started using
Hydrotherapy	Hydrotherapy Never or rarely used	Hydrotherapy Cannot use it now	Hydrotherapy Decreased use	Hydrotherapy No change	Hydrotherapy Increased use	Hydrotherapy Recently started using
Nordic Walking	Nordic Walking Never or rarely used	Nordic Walking Cannot use it now	Nordic Walking Decreased use	Nordic Walking No change	Nordic Walking Increased use	Nordic Walking Recently started using
Cryotherapy, Heat therapy, electrotherapy, magnetotherapy	Cryotherapy, Heat therapy, electrotherapy, magnetotherapy Never or rarely used	Cryotherapy, Heat therapy, electrotherapy, magnetotherapy Cannot use it now	Cryotherapy, Heat therapy, electrotherapy, magnetotherapy Decreased use	Cryotherapy, Heat therapy, electrotherapy, magnetotherapy No change	Cryotherapy, Heat therapy, electrotherapy, magnetotherapy Increased use	Cryotherapy, Heat therapy, electrotherapy, magnetotherapy Recently started using
Virtual reality, gaming technology	Virtual reality, gaming technology Never or rarely used	Virtual reality, gaming technology Cannot use it now	Virtual reality, gaming technology Decreased use	Virtual reality, gaming technology No change	Virtual reality, gaming technology Increased use	Virtual reality, gaming technology Recently started using
Music therapy, dance therapy	Music therapy, dance therapy Never or rarely used	Music therapy, dance therapy Cannot use it now	Music therapy, dance therapy Decreased use	Music therapy, dance therapy No change	Music therapy, dance therapy Increased use	Music therapy, dance therapy Recently started using
Pain control	Pain control Never or rarely used	Pain control Cannot use it now	Pain control Decreased use	Pain control No change	Pain control Increased use	Pain control Recently started using
Robotic-assisted rehabilitation therapy, sensor assisted rehabilitation	Robotic-assisted rehabilitation therapy, sensor assisted rehabilitation Never or rarely used	Robotic-assisted rehabilitation therapy, sensor assisted rehabilitation Cannot use it now	Robotic-assisted rehabilitation therapy, sensor assisted rehabilitation Decreased use	Robotic-assisted rehabilitation therapy, sensor assisted rehabilitation No change	Robotic-assisted rehabilitation therapy, sensor assisted rehabilitation Increased use	Robotic-assisted rehabilitation therapy, sensor assisted rehabilitation Recently started using
Cognitive, perceptual, visual, or sensory perceptual training	Cognitive, perceptual, visual, or sensory perceptual training Never or rarely used	Cognitive, perceptual, visual, or sensory perceptual training Cannot use it now	Cognitive, perceptual, visual, or sensory perceptual training Decreased use	Cognitive, perceptual, visual, or sensory perceptual training No change	Cognitive, perceptual, visual, or sensory perceptual training Increased use	Cognitive, perceptual, visual, or sensory perceptual training Recently started using

Other (please specify)

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* 14. Type of use during the Covid-19 pandemic- Answer when applicable

	Online only	Both online and face to face	Face to face only
Aerobic training, conditioning exercises	Aerobic training, conditioning exercises Online only	Aerobic training, conditioning exercises Both online and face to face	Aerobic training, conditioning exercises Face to face only
Strengthening, resistance training	Strengthening, resistance training Online only	Strengthening, resistance training Both online and face to face	Strengthening, resistance training Face to face only
Stretching	Stretching Online only	Stretching Both online and face to face	Stretching Face to face only
Relaxation techniques, e.g. yoga, tai-chi	Relaxation techniques, e.g. yoga, tai-chi Online only	Relaxation techniques, e.g. yoga, tai-chi Both online and face to face	Relaxation techniques, e.g. yoga, tai-chi Face to face only
Classical PT procedures (Bobath, PNF, Perfetti, Frenkel, Petö, Rood, Perfetti)	Classical PT procedures (Bobath, PNF, Perfetti, Frenkel, Petö, Rood, Perfetti) Online only	Classical PT procedures (Bobath, PNF, Perfetti, Frenkel, Petö, Rood, Perfetti) Both online and face to face	Classical PT procedures (Bobath, PNF, Perfetti, Frenkel, Petö, Rood, Perfetti) Face to face only
Balance training (static, dynamic), postural awareness	Balance training (static, dynamic), postural awareness Online only	Balance training (static, dynamic), postural awareness Both online and face to face	Balance training (static, dynamic), postural awareness Face to face only
Balance platform (devices for proprioceptive posture therapy)	Balance platform (devices for proprioceptive posture therapy) Online only	Balance platform (devices for proprioceptive posture therapy) Both online and face to face	Balance platform (devices for proprioceptive posture therapy) Face to face only
Dual tasking	Dual tasking Online only	Dual tasking Both online and face to face	Dual tasking Face to face only
Orthotic devices assessment and training	Orthotic devices assessment and training Online only	Orthotic devices assessment and training Both online and face to face	Orthotic devices assessment and training Face to face only
Pelvic floor exercises	Pelvic floor exercises Online only	Pelvic floor exercises Both online and face to face	Pelvic floor exercises Face to face only
Conductive education programme	Conductive education programme Online only	Conductive education programme Both online and face to face	Conductive education programme Face to face only
Constraint-Induced movement therapy	Constraint-Induced movement therapy Online only	Constraint-Induced movement therapy Both online and face to face	Constraint-Induced movement therapy Face to face only
Training of activities of daily living	Training of activities of daily living Online only	Training of activities of daily living Both online and face to face	Training of activities of daily living Face to face only

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* 15. cont.....

	Online only	Both Face to Face and Online	Face to Face only
Fatigue management program	Fatigue management program Online only	Fatigue management program Both Face to Face and Online	Fatigue management program Face to Face only
Treadmill training, body weight support walking training	Treadmill training, body weight support walking training Online only	Treadmill training, body weight support walking training Both Face to Face and Online	Treadmill training, body weight support walking training Face to Face only
Biofeedback, electrical stimulation	Biofeedback, electrical stimulation Online only	Biofeedback, electrical stimulation Both Face to Face and Online	Biofeedback, electrical stimulation Face to Face only
Hippotherapy	Hippotherapy Online only	Hippotherapy Both Face to Face and Online	Hippotherapy Face to Face only
Hydrotherapy	Hydrotherapy Online only	Hydrotherapy Both Face to Face and Online	Hydrotherapy Face to Face only
Nordic Walking	Nordic Walking Online only	Nordic Walking Both Face to Face and Online	Nordic Walking Face to Face only
Cryotherapy, Heat therapy, electrotherapy, magnetotherapy	Cryotherapy, Heat therapy, electrotherapy, magnetotherapy Online only	Cryotherapy, Heat therapy, electrotherapy, magnetotherapy Both Face to Face and Online	Cryotherapy, Heat therapy, electrotherapy, magnetotherapy Face to Face only
Virtual reality, gaming technology	Virtual reality, gaming technology Online only	Virtual reality, gaming technology Both Face to Face and Online	Virtual reality, gaming technology Face to Face only
Music therapy, dance therapy	Music therapy, dance therapy Online only	Music therapy, dance therapy Both Face to Face and Online	Music therapy, dance therapy Face to Face only
Manual therapy	Manual therapy Online only	Manual therapy Both Face to Face and Online	Manual therapy Face to Face only
Pain control	Pain control Online only	Pain control Both Face to Face and Online	Pain control Face to Face only
Robotic-assisted rehabilitation therapy, sensor assisted rehabilitation	Robotic-assisted rehabilitation therapy, sensor assisted rehabilitation Online only	Robotic-assisted rehabilitation therapy, sensor assisted rehabilitation Both Face to Face and Online	Robotic-assisted rehabilitation therapy, sensor assisted rehabilitation Face to Face only
Cognitive, perceptual, visual, or sensory perceptual training	Cognitive, perceptual, visual, or sensory perceptual training Online only	Cognitive, perceptual, visual, or sensory perceptual training Both Face to Face and Online	Cognitive, perceptual, visual, or sensory perceptual training Face to Face only

Other (please specify)

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* 16. BEFORE Covid-19 pandemic (2019), in which kind of organizational framework did you work?

I used to work independently.

I used to work in a multidisciplinary team (Multidisciplinary team defined as specialists who work in parallel towards addressing problems related to their profession.)

I used to work in an interdisciplinary team (Interdisciplinary team defined as (specialists working as a group to achieve a common goal that is explicitly agreed upon)

Individual PT practice

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* 17. If you worked in a team, please write the number of people working together in multidisciplinary rehabilitation team?

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* 18. Concerning their rehabilitation BEFORE the pandemic, were your patients involved in the goal setting process?

Yes

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* 19. DURING Covid-19 pandemic (2020), in which kind of organizational framework did you work?

I worked independently.

I worked in a multidisciplinary team (Multidisciplinary team defined as specialists who work in parallel towards addressing problems related to their profession.)

I worked in an interdisciplinary team (Interdisciplinary team defined as (specialists working as a group to achieve a common goal that is explicitly agreed upon)

Individual PT practice.

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* 20. If you worked in a team DURING the pandemic, please write the number of people working together in multidisciplinary rehabilitation team?

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* 21. Concerning their rehabilitation DURING the pandemic, were your patients involved in the goal setting process?

Yes

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* 22. During a standard treatment BEFORE Covid-19 pandemic (2019), how much time (% of the treatment session) do you use “hands-on” (manual) therapy, verbal instructions and demonstrations. Please define for each type of MS patient. (Your answer should total 100%).

* "Hands on" includes manual therapy techniques and also facilitation of movement using the therapist’s hands on the patient’s body
* Verbal instruction defined as giving oral instructions and cueing to the patient regarding their exercises, their gait and any other type of functional movement patterns.
* Demonstration defined as physically showing the patient how to do an exercise or a functional movement pattern by demonstrating the movement first yourself.

Mobility MILDLY impaired (no walking aids): (Total must be 100%)

	0	10	20	30	40	50	60	70	80	90	100
“Hands on”* / Manual treatment	“Hands on”* / Manual treatment 0	“Hands on”* / Manual treatment 10	“Hands on”* / Manual treatment 20	“Hands on”* / Manual treatment 30	“Hands on”* / Manual treatment 40	“Hands on”* / Manual treatment 50	“Hands on”* / Manual treatment 60	“Hands on”* / Manual treatment 70	“Hands on”* / Manual treatment 80	“Hands on”* / Manual treatment 90	“Hands on”* / Manual treatment 100
Verbal instruction*	Verbal instruction* 0	Verbal instruction* 10	Verbal instruction* 20	Verbal instruction* 30	Verbal instruction* 40	Verbal instruction* 50	Verbal instruction* 60	Verbal instruction* 70	Verbal instruction* 80	Verbal instruction* 90	Verbal instruction* 100
Demonstration*	Demonstration* 0	Demonstration* 10	Demonstration* 20	Demonstration* 30	Demonstration* 40	Demonstration* 50	Demonstration* 60	Demonstration* 70	Demonstration* 80	Demonstration* 90	Demonstration* 100
Other	Other 0	Other 10	Other 20	Other 30	Other 40	Other 50	Other 60	Other 70	Other 80	Other 90	Other 100

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* 23. During a standard treatment BEFORE Covid-19 pandemic (2019), how much time (% of the treatment session) do you use “hands-on” (manual) therapy, verbal instructions and demonstrations. Please define for each type of MS patient. (Your answer should total 100%).

Mobility MODERATELY impaired (cane/s and rollator): (Total must be 100%)

	0	10	20	30	40	50	60	70	80	90	100
“Hands on”* / Manual treatment	“Hands on”* / Manual treatment 0	“Hands on”* / Manual treatment 10	“Hands on”* / Manual treatment 20	“Hands on”* / Manual treatment 30	“Hands on”* / Manual treatment 40	“Hands on”* / Manual treatment 50	“Hands on”* / Manual treatment 60	“Hands on”* / Manual treatment 70	“Hands on”* / Manual treatment 80	“Hands on”* / Manual treatment 90	“Hands on”* / Manual treatment 100
Verbal instruction*	Verbal instruction* 0	Verbal instruction* 10	Verbal instruction* 20	Verbal instruction* 30	Verbal instruction* 40	Verbal instruction* 50	Verbal instruction* 60	Verbal instruction* 70	Verbal instruction* 80	Verbal instruction* 90	Verbal instruction* 100
Demonstration*	Demonstration* 0	Demonstration* 10	Demonstration* 20	Demonstration* 30	Demonstration* 40	Demonstration* 50	Demonstration* 60	Demonstration* 70	Demonstration* 80	Demonstration* 90	Demonstration* 100
Other	Other 0	Other 10	Other 20	Other 30	Other 40	Other 50	Other 60	Other 70	Other 80	Other 90	Other 100

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* 24. During a standard treatment BEFORE Covid-19 pandemic (2019), how much time (% of the treatment session) do you use “hands-on” (manual) therapy, verbal instructions and demonstrations. Please define for each type of MS patient. (Your answer should total 100%).

Mobility SEVERELY impaired (wheelchair users): (Total must be 100%)

	0	10	20	30	40	50	60	70	80	90	100
“Hands on”* / Manual treatment	“Hands on”* / Manual treatment 0	“Hands on”* / Manual treatment 10	“Hands on”* / Manual treatment 20	“Hands on”* / Manual treatment 30	“Hands on”* / Manual treatment 40	“Hands on”* / Manual treatment 50	“Hands on”* / Manual treatment 60	“Hands on”* / Manual treatment 70	“Hands on”* / Manual treatment 80	“Hands on”* / Manual treatment 90	“Hands on”* / Manual treatment 100
Verbal instruction*	Verbal instruction* 0	Verbal instruction* 10	Verbal instruction* 20	Verbal instruction* 30	Verbal instruction* 40	Verbal instruction* 50	Verbal instruction* 60	Verbal instruction* 70	Verbal instruction* 80	Verbal instruction* 90	Verbal instruction* 100
Demonstration*	Demonstration* 0	Demonstration* 10	Demonstration* 20	Demonstration* 30	Demonstration* 40	Demonstration* 50	Demonstration* 60	Demonstration* 70	Demonstration* 80	Demonstration* 90	Demonstration* 100
Other	Other 0	Other 10	Other 20	Other 30	Other 40	Other 50	Other 60	Other 70	Other 80	Other 90	Other 100

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* 25. During a standard treatment DURING Covid-19 pandemic (2020), how much time (% of the treatment session) do you use “hands-on” (manual) therapy, verbal instructions and demonstrations. Please define for each type of MS patient. (Your answer should total 100%).

* "Hands on" includes manual therapy techniques and also facilitation of movement using the therapist’s hands on the patient’s body
* Verbal instruction defined as giving oral instructions and cueing to the patient regarding their exercises, their gait and any other type of functional movement patterns.
* Demonstration defined as physically showing the patient how to do an exercise or a functional movement pattern by demonstrating the movement first yourself.

Mobility MILDLY impaired (no walking aids): (Total must be 100%)

	0	10	20	30	40	50	60	70	80	90	100
“Hands on”* / Manual treatment	“Hands on”* / Manual treatment 0	“Hands on”* / Manual treatment 10	“Hands on”* / Manual treatment 20	“Hands on”* / Manual treatment 30	“Hands on”* / Manual treatment 40	“Hands on”* / Manual treatment 50	“Hands on”* / Manual treatment 60	“Hands on”* / Manual treatment 70	“Hands on”* / Manual treatment 80	“Hands on”* / Manual treatment 90	“Hands on”* / Manual treatment 100
Verbal instruction*	Verbal instruction* 0	Verbal instruction* 10	Verbal instruction* 20	Verbal instruction* 30	Verbal instruction* 40	Verbal instruction* 50	Verbal instruction* 60	Verbal instruction* 70	Verbal instruction* 80	Verbal instruction* 90	Verbal instruction* 100
Demonstration*	Demonstration* 0	Demonstration* 10	Demonstration* 20	Demonstration* 30	Demonstration* 40	Demonstration* 50	Demonstration* 60	Demonstration* 70	Demonstration* 80	Demonstration* 90	Demonstration* 100
Other	Other 0	Other 10	Other 20	Other 30	Other 40	Other 50	Other 60	Other 70	Other 80	Other 90	Other 100

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* 26. During a standard treatment DURING Covid-19 pandemic (2020), how much time (% of the treatment session) do you use “hands-on” (manual) therapy, verbal instructions and demonstrations. Please define for each type of MS patient. (Your answer should total 100%).

Mobility MODERATELY impaired (cane/s and rollator): (Total must be 100%)

	0	10	20	30	40	50	60	70	80	90	100
“Hands on”* / Manual treatment	“Hands on”* / Manual treatment 0	“Hands on”* / Manual treatment 10	“Hands on”* / Manual treatment 20	“Hands on”* / Manual treatment 30	“Hands on”* / Manual treatment 40	“Hands on”* / Manual treatment 50	“Hands on”* / Manual treatment 60	“Hands on”* / Manual treatment 70	“Hands on”* / Manual treatment 80	“Hands on”* / Manual treatment 90	“Hands on”* / Manual treatment 100
Verbal instruction*	Verbal instruction* 0	Verbal instruction* 10	Verbal instruction* 20	Verbal instruction* 30	Verbal instruction* 40	Verbal instruction* 50	Verbal instruction* 60	Verbal instruction* 70	Verbal instruction* 80	Verbal instruction* 90	Verbal instruction* 100
Demonstration*	Demonstration* 0	Demonstration* 10	Demonstration* 20	Demonstration* 30	Demonstration* 40	Demonstration* 50	Demonstration* 60	Demonstration* 70	Demonstration* 80	Demonstration* 90	Demonstration* 100
Other	Other 0	Other 10	Other 20	Other 30	Other 40	Other 50	Other 60	Other 70	Other 80	Other 90	Other 100

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* 27. During a standard treatment DURING Covid-19 pandemic (2020), how much time (% of the treatment session) do you use “hands-on” (manual) therapy, verbal instructions and demonstrations. Please define for each type of MS patient. (Your answer should total 100%).

Mobility SEVERELY impaired (wheelchair users): (Total must be 100%)

	0	10	20	30	40	50	60	70	80	90	100
“Hands on”* / Manual treatment	“Hands on”* / Manual treatment 0	“Hands on”* / Manual treatment 10	“Hands on”* / Manual treatment 20	“Hands on”* / Manual treatment 30	“Hands on”* / Manual treatment 40	“Hands on”* / Manual treatment 50	“Hands on”* / Manual treatment 60	“Hands on”* / Manual treatment 70	“Hands on”* / Manual treatment 80	“Hands on”* / Manual treatment 90	“Hands on”* / Manual treatment 100
Verbal instruction*	Verbal instruction* 0	Verbal instruction* 10	Verbal instruction* 20	Verbal instruction* 30	Verbal instruction* 40	Verbal instruction* 50	Verbal instruction* 60	Verbal instruction* 70	Verbal instruction* 80	Verbal instruction* 90	Verbal instruction* 100
Demonstration*	Demonstration* 0	Demonstration* 10	Demonstration* 20	Demonstration* 30	Demonstration* 40	Demonstration* 50	Demonstration* 60	Demonstration* 70	Demonstration* 80	Demonstration* 90	Demonstration* 100
Other	Other 0	Other 10	Other 20	Other 30	Other 40	Other 50	Other 60	Other 70	Other 80	Other 90	Other 100

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* 28. Therapeutic session - BEFORE Covid (2019)

Please, specify the average therapeutic session (including virtual or face to face treatment) provided by you, per patient, BEFORE Covid-19 pandemic (2019)

Length of session (in minutes)

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* 29. Number of sessions per week (if less than once per week, please indicate the frequency)

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* 30. Total number of sessions

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* 31. Therapeutic session - DURING Covid (2020)

Please, specify the average therapeutic session (including virtual or face to face treatment) provided by you, per patient, DURING Covid-19 pandemic (2020)

Length of session (in minutes)

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* 32. Number of sessions per week (if less than once per week, please indicate the frequency)

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Physiotherapy exercise website

Exercise class on the TV

Other technology

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* 41. Please answer if you use any of the following technologies with your patients DURING Covid pandemic (2020)

Wearable device - e.g. FitBit, Smart Watch, Pedometer

App on my phone, laptop or tablet

Recorded video on a device

Physiotherapy exercise website

Exercise class on the TV

Other technology

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* 42. If telerehabilitation has been used DURING the Covid pandemic (2020), what were the challenges you faced? Please choose the THREE most relevant.

No difficulties

Lack of equipment

Not possible to facilitate proprioceptive cues

Unable to understand patients body language

Instructing patients on use of platforms for telerehab

Limited assessment

Increased time needed for technical setup

Low confidence in using platforms

Difficult defining interdisciplinary goals.

Safety concerns during the session

Privacy and online security

Difficulty detecting disease progression or deconditioning

Other (please specify)

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* 43. How do you feel about delivering your interventions DURING the Covid pandemic (2020)? Please, choose the THREE most relevant

Anxious

Scared

Relieved

Reluctant

Hesitant

positve

optimistic

Worried

Sad

Frustrated

Stressed

Depressed

Other (please specify)

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* 44. Did you agree with the rules and regulations set out in your workplace for COVID-19 protection (including personal protective equipment in face to face sessions and data security protection in online sessions)?

Yes

N/A

Question Title

* 45. Organizational changes DURING Covid (2020)

During 2020 some organizational, employer and employee impact may have occurred in your workplace. Please describe to what extent (duration in number of months) these changes occurred.

Stop face to face rehabilitation (number of months)

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* 46. At which month did the stop of face to face sessions occur

Did not stop

January

February

March

April

May

June

July

August

September

October

November

December

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* 47. Stop clinical research (number of months)

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* 48. Stop or reduce the number of students on placement in practice (number of months)

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* 49. Changes in educational courses/professional development for staff (number of months)

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* 50. Was your income affected during the pandemic?

Increased

Decreased

No change

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* 51. Did your working conditions as a PT change DURING the Covid-19 pandemic (2020)? (select ONE answer)

No change

Unemployed

Reduction in working hours

Increase in working hours

Redeployed to a different department/population group (including Covid-19 patients)

Shift to tele-rehabilitation

Question Title

* 52. What percentage of your work changed to telerehabilitation during the COVID-19 pandemic in 2020?

Thank you for completing the survey. The results will be made available through the RIMS network and through ISCP/CPNG events later on.

QUESTIONNAIRE ON PHYSICAL REHABILITATION IN MULTIPLE SCLEROSIS DURING THE COVID PANDEMIC_PROFESSIONALS