Physical therapist, UC Health; Cochair, International Organization of MS Rehabilitation Therapists (IOMSRT)

Patricia Bobryk, MHS, PT, MSCS, ATP

“It can be very overwhelming, particularly for the newly diagnosed, with all of this information coming in. If you can convey to the patient that you have this team of people, particularly the core team of people…that is going to provide care, be your advocate, and provide the resources and education for you—there is great comfort in that.”

As has been the trend across medicine in recent years, many practices have begun to implement a more comprehensive approach to patient care. For those with multiple sclerosis (MS), this model of care allows for a more holistic treatment regimen that is able to address the needs of the patient with regard to treatment and disease management.

One common member of this care team model is a physical therapist or rehabilitation specialist, such as Patricia Bobryk, MHS, PT, MSCS, ATP. A physical therapist at UC Health and the cochair of the 

International Organization of MS Rehabilitation Therapists (IOMSRT)

, Bobryk explained that incorporating this approach to MS care provides a more all-encompassing model that can address not only clinical disease progression, but symptomatic issues and other “invisible” consequences of the disease. This approach, she noted, particularly blends with the increased voice of the patient in the shared decision-making process.

, Bobyrk offered her expertise in the care of this patient population, expressing the importance of consistent messaging for patient education among the individual team members as well as the need for the incorporation of key members early in the disease process.

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The physical therapist at UC Health and cochair of the International Organization of MS Rehabilitation Therapists discussed the importance of the care team for patients with MS and the role effective communication plays. [WATCH TIME: 4 minutes]

Effective Comprehensive Care Team Communication in MS: Patricia Bobryk, MHS, PT, MSCS, ATP

“If a patient walks away knowing that maybe they don’t have the solution yet for [a given] issue, but it’s being addressed and they’re going to see the appropriate professional that’s going to help them with it, they’re going to walk away fulfilled and [feeling that] their needs have been met.”

For patients with multiple sclerosis (MS), there are several symptoms and consequences of the disease that allow them to benefit from engaging in rehabilitation strategies. Because of this, those patients who have access to larger care teams are often seen by a physical or occupational therapist who specializes in the management of MS.

Patricia Bobryk, MHS, PT, MSCS, ATP, offers this type of care, and spoke with 

 in an interview about the benefits it can provide. Specifically, Bobryk, who is a physical therapist at UC Health, and the cochair of the International Organization of MS Rehabilitation Therapists (IOMSRT), explained that this type of care is particularly helpful in addressing the patient-focused needs around issues with mobility and speech, for example. She added that the need to provide patients with MS the care that they feel they require is critical to their long-term outcomes.

Bobryk also shared her insight into how this focus on patient-centered care and shared decision-making melds nicely into the ongoing shift to the use of comprehensive multidisciplinary care teams to manage disease. Interplay between the physical therapist, speech pathologist, MS specialist, and other members of the team is critical to ensuring that patients’ needs are met—something that can only be achieved by proper referral and communication.

With the field of multiple sclerosis care focusing on the importance of patient-reported outcomes and shared decision-making, the physical therapist at UC Health and cochair of the International Organization of MS Rehabilitation Therapists offered commentary.

The Critical Nature of Patient-Focused MS Care: Patricia Bobryk, MHS, PT, MSCS, ATP

“Unfortunately, if patients get a referral for therapy and they’re not directed to specialized care, they might just say, ‘Oh, the corner therapist is more convenient to me.’ And maybe they’re getting good care there, but maybe it’s an ortho-based philosophy of care, which is not the most effective or efficient or the standard of practice for MS care.”

For patients with multiple sclerosis (MS), like many neurologic and neurodegenerative diseases, the need for physical therapy and rehabilitative medicine as a part of the care paradigm is imperative to ensure good outcomes. Although many patients seek care at larger institutions with multidisciplinary care teams, there remains a gap in access to good rehabilitative professionals for a number of the 2 million individuals in the US with MS.

Patricia Bobryk, MHS, PT, MSCS, ATP, explained to 

 that the reasons for this stem from a number of places, including the supply-and-demand issue related to the number of available physical therapists with specialized training. Patients with MS often require a specific approach that not all rehabilitative professionals can provide without proper education. This can lead to individuals utilizing benefits to see providers who may not be able to offer them the precise type of care they require.

To find out more about these challenges and the efforts that are ongoing to address them, Bobyrk, who is a physical therapist at UC Health and the cochair of the 

, shared her insight from more than 20 years of experience in the field. She also spoke to the underutilized tools and underrecognized needs that must be used and met for these patients—the care for much of which may only be available from specialized clinicians.­

Amid an ongoing national shortage of clinicians who treat neurologic diseases like MS, the cochair of the International Organization of MS Rehabilitation Therapists discussed the availability of rehabilitation professionals for patients.

The Availability of MS Rehabilitation Therapists: Patricia Bobryk, MHS, PT, MSCS, ATP

“Establishing those relationships [with patients] are really key early on [in care]. We can do baseline testing and we can get to really know a person, early on, so we know where their level of function is, we can understand what their goals are and what’s important to them. If we establish that early on, we can help promote that health and wellness and quality of life throughout the continuum of MS.”

 would likely benefit from engaging in rehabilitation strategies to aid in the management of symptoms and disease-related challenges, many patients do not reap these benefits early enough in the disease process.

 Additionally, there remains a longstanding need for more inquiry into the optimal implementation of the many varied modalities through which rehabilitative treatment can be applied.

Not unlike the conversations around the benefits of early initiation of disease-modifying therapy, many physical therapists and rehabilitation specialists have called for the earlier introduction of treatment. One such specialist is Patricia Bobryk, MHS, PT, MSCS, ATP, physical therapist, UC Health, and cochair, 

, who explained that early introduction of these approaches to patients can reap benefits for them in several ways—particularly in establishing an accurate baseline and long-term goals.

, Bobyrk explained the current state of rehabilitative care for patients with MS and the importance of initiating that care process early on, as well as how it fits into the comprehensive care model. She provided insight into the drivers of referrals to specialists like herself and how she’s gone about promoting the need for rehab for these patients.

REFERENCES
1. Rohrig M. Physical Therapy in Multiple Sclerosis. National Multiple Sclerosis Society. Published 2018. Accessed September 9, 2021. https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Clinical_Bulletin_Physical-Therapy-in-MS-Rehabilitation.pdf
2. Motl RW, Sandroff BM, Kwakkel G, et al. Exercise in patients with multiple sclerosis. 

. 2017;16(10):848-856. doi:10.1016/S1474-4422(17)30281-8.
3. Paltamaa J, Sjögren T, Peurala SH, Heinonen A. Effects of physiotherapy interventions on balance in multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials. 

. 2012;44(10):811-23. doi:10.2340/16501977-1047
4. Etoom M, Khraiwesh Y, Lena F, et al. Effectiveness of Physiotherapy Interventions on Spasticity in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis. 

. 2018;97(11):793-807. doi:10.1097/PHM.0000000000000970
5. Khan F, Amatya B. Rehabilitation in Multiple Sclerosis: A Systematic Review of Systematic Reviews. 

. 2017;98(2):353-367. doi:10.1016/j.apmr.2016.04.016

The physical therapist at UC Health and cochair of the International Organization of MS Rehabilitation Therapists spoke to the current standards of rehabilitative care among patients with multiple sclerosis.

Patricia Bobryk, MHS, PT, MSCS, ATP

Articles

Effective Comprehensive Care Team Communication in MS: Patricia Bobryk, MHS, PT, MSCS, ATP

The Critical Nature of Patient-Focused MS Care: Patricia Bobryk, MHS, PT, MSCS, ATP

The Availability of MS Rehabilitation Therapists: Patricia Bobryk, MHS, PT, MSCS, ATP

Early Intervention With Physical Therapy for MS: Patricia Bobryk, MHS, PT, MSCS, ATP

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