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Table 1 Definitions of the four IMCO elements – examples from four practitioners in the team, regarding the same MS patient

From: An investigation of multidisciplinary complex health care interventions – steps towards an integrative treatment model in the rehabilitation of People with Multiple Sclerosis

  Intervention Mechanisms Contexts Outcomes- expected Outcomes- obtained this far
Medical doctor “Tablet Carduran 8 mg daily” Adrenergic Alfa-receptor blocking effect on post synaptic Alfa 1-receptors, whereby the urethrale resistance is reduced “Compliance promotes the treatment” “Improved bladder discharge and reduction of pollakiuria” “Reduction of frequent urination urge”
Physical therapist “Therapeutic horseback riding” “Strengthens the balance and stimulates the walking pattern” “The treatment is promoted by the patient’s motivation and inhibited by the risk of skin chafing due to low body weight” “Improvement of balance and walking pattern” “Walking pattern is more relaxed”
Nutritional therapist “An MS diet with a high intake of vegetables, fibres and fish and a low intake of saturated fatty acids and sugar” “A lower intake of saturated fatty acids reduces the level of inflammatory eicosaniods and thereby limits the inflammatory pain” “The patient needs to enter a positive circle where a changed diet provides the energy needed to continue a positive process. Smoking inhibites the treatment” “Less tiredness, less pain and more energy” “The patient has more energy, has regained a feeling of freedom and optimism. The mood has been improved”
Homeopath “Agaricus C200, Arnica C30, Natrium, Muriaticum C200 and 1 M” “The homeopathic remedies stimulate the patient’s self healing powers at different levels” “The patient’s participation, motivation and willingness to cooperate promotes the treatment. The patient is emotionally burdened, which inhibites the treatment” “Improvements on the emotional level, better accept of own situation. Improvement of walk and balance” “Improvements on the emotional level. More energy mentally and physically. Better physical endurance. Improvement of spasms in legs”