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


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.

“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.”

Although the majority of patients with multiple sclerosis (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.1-3 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.4,5

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, International Organization of MS Rehabilitation Therapists (IOMSRT), 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.

In a conversation with NeurologyLive, 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.

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. Lancet Neurol. 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. J Rehabil Med. 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. Am J Phys Med Rehabil. 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. Arch Phys Med Rehabil. 2017;98(2):353-367. doi:10.1016/j.apmr.2016.04.016
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