Epidemiology of physiotherapy utilization among adults and elderly

Abstract

ObjectiveTo analyze the prevalence of physiotherapy utilization and to explore the variables associated to its utilization. Methods A population-based cross-sectional study, including 3,100 subjects aged 20 years or more living in the urban area of Pelotas, southern Brazil, was carried out. The sample was selected following a multiple-stage protocol; the census tracts delimited by the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics) were the primary sample units. Following descriptive and crude analyses, Poisson regression models taking the clustering of the sample into account were carried out. Data were collected through face-to-face interviews using a standardized and pre-tested questionnaire. ResultsThe lifetime utilization of physiotherapy was 30.2%; and physiotherapy utilization in the 12 months prior to the interview was reported by 4.9%. Women, elderly subjects, and those from higher socioeconomic levels were more likely to use physiotherapy. Restricting analysis to subjects who attended physiotherapy, 66% used public health services, 25% used insurance health services and 9% had private sessions. Conclusions This is the first population-based study on physiotherapy utilization carried out in Brazil. Utilization of physio therapy was lower than reported in both developed and developing countries. The study findings might help public health authorities to organize healthcare service in terms of this important demand. Resumo Objetivo

Queixas musculoesqueléticas em uma Unidade Básica de Saúde: implicações para o planejamento das ações em saúde e fisioterapia

“…Among the complaints related to physical therapy, musculoskeletal ones were the prevalent, corroborating the data by Moretto et al 8 and Siqueira et al 7 . Out of the assessed variables, it is more likely for people aged more than 40 years old to look for the health unit due to complaints.…”

“…When verifying the profile of users in relation to gender, our data corroborate those of other authors, showing that women care more for their health 13 , be it in a health unit 14 or in the search for public and private services 7 . According to Gomes et al 15 , men look less for health services because the role of being a man in our society makes it difficult to practice self-care.…”

“…Epidemiological analyses conducted in different regions of the country on the demands of patients with musculoskeletal complaints can provide data concerning the need for physical therapy 7,8 . Esperança et al 4 analyzed the demand in a family health unit of a medium-sized city and found 9% of the complaints were related to the musculoskeletal system, while Barros et al 9 , when analyzing data of National Household Sample Survey in 2003, showed that spinal pain was the most prevalent chronic pathology.…”

Prevalência de dor nas costas e fatores associados em adultos do sul do Brasil: estudo de base populacional

“…Some epidemiological studies attribute this finding to an information bias 32 , however, it is plausible, since women, more and more, combine the execution of domestic tasks and jobs done out of home, where they are exposed to ergonomic loads, especially the repeatability, vicious positions and high velocity tasks' performance 33 . In addition, the female gender presents some anatomic functional characteristics (smaller stature, smaller muscle and bone masses, frail joints and less adapted to strenuous physical efforts as well as having a higher proportion of fat) 1,34,35 and others related to the nervous system which can collaborate to the emergence and increase of pain intensity 36,37 . The worst the health perception, the higher was the risk to have spinal pain (p<0.001).…”

Perfil clínico dos pacientes atendidos em um ambulatório de fisioterapia em oncologia do município de São Paulo

“…No entanto, sabe-se que a atuação fisioterapêutica mais precoce no pós--operatório de pacientes submetidas às mastectomias pode prevenir uma série de complicações e garantir uma recuperação mais rápida 16 . Por meio desse achado, pode-se observar a necessidade de adequação no atendimento a pacientes em fase pós-operatória, questão observada em muitos serviços do SUS 19 . Como proposta, sugere-se a distribuição de cartilhas de orientação e palestras informativas quanto aos cuidados pré e pós-operatórios, bem como o de encaminhamento médi-co mais precoce à fisioterapia, e deve-se considerar que é comum o desenvolvimento de sequelas como o linfedema mais tardiamente, levando o paciente a procurar a fisioterapia somente após sua instalação 20 .…”