A mixed methods study exploring factors that impact physiotherapy participation for people with Parkinson's disease.

Abstract

It is unclear if people with Parkinson's disease (pwPD) are accessing sufficient and timely physiotherapy. This study aimed to determine the need for physiotherapy for pwPD, understand if this need is being met and identify barriers and enablers to accessing physiotherapy. A two-stage mixed-methods approach was undertaken. In Stage 1, a retrospective audit of medical records from 80 pwPD attending a publicly funded movement disorders outpatient clinic in Australia was conducted, followed by phone interviews to quantify need, referral, and uptake of physiotherapy. Stage 2 involved semi-structured interviews and focus groups with staff and patients to explore factors influencing physiotherapy access. Focus group and interview data were transcribed and analysed using thematic analysis. Audited records revealed that most pwPD were deemed in need of physiotherapy (83%), but many (61%), were not recommended physiotherapy. Three major themes were identified as contributing; (1) how can physiotherapy help and what is available? (2) too hard basket and (3) financially, that's not feasible. Access to physiotherapy for pwPD is limited and occurs later in the disease process. The findings suggest that early individualised education, staff training, identification and provision of suitable physiotherapy services close to patients' homes could improve access.