Physical therapy and chiropractic use among childhood cancer survivors with chronic disease: impact on health-related quality of life

Abstract

Introduction-The use of rehabilitation services to address musculoskeletal, neurological and cardiovascular late effects among childhood cancer survivors could improve physical function and health-related quality-of-life (HRQL). We describe physical therapy (PT) and chiropractic utilization among childhood cancer survivors and their association with HRQL.

Effect of health insurance on the utilisation of allied health services by people with chronic disease: a systematic review and meta-analysis

“…Despite the frequent inclusion of age as a covariate in regression models, it was not associated with utilisation except in a single study; however, this was not consistent across multiple time points (Montgomery et al 2011). Gender was not found to be a significant covariate in some subgroups (Ostwald et al 2009;Montgomery et al 2011) although males were more likely to utilise occupational therapy following stroke (Ostwald et al 2009).…”

“…However, the presence of multiple other impairments did not change utilisation except for people with hemiparesis or hemiplegia who had an increased utilisation of physiotherapy on bivariate analysis (Ostwald et al 2009). Having a chronic disease classified as severe, life-threatening or disabling was associated with increased utilisation of physiotherapy but not chiropractic (Montgomery et al 2011), indicating differences in the severity of patients seen by these different professional groups. Pain may contribute to both individual-perceived need for allied health services and need as evaluated by health professionals.…”

“…Pain may contribute to both individual-perceived need for allied health services and need as evaluated by health professionals. The presence of pain along with the use of pain medication and muscle relaxants was independently associated with utilisation of physiotherapy and chiropractic in survivors of childhood cancer (Montgomery et al 2011). Inpatient hospital length of stay did not affect post-discharge utilisation of allied health in people with stroke (Ostwald et al 2009).…”

“…Gender was not found to be a significant covariate in some subgroups (Ostwald et al 2009;Montgomery et al 2011) although males were more likely to utilise occupational therapy following stroke (Ostwald et al 2009). Race did influence allied health service utilisation independently of insurance; however, the nature of the relationship varied across clinical populations, for example, one study reported that Hispanics were more likely to use physiotherapy whereas black patients were less likely to use physiotherapy or chiropractic services (Montgomery et al 2011).…”

“…Gender was not found to be a significant covariate in some subgroups (Ostwald et al 2009;Montgomery et al 2011) although males were more likely to utilise occupational therapy following stroke (Ostwald et al 2009). Race did influence allied health service utilisation independently of insurance; however, the nature of the relationship varied across clinical populations, for example, one study reported that Hispanics were more likely to use physiotherapy whereas black patients were less likely to use physiotherapy or chiropractic services (Montgomery et al 2011). Contrasting findings were reported where a reduction in physiotherapy utilisation was observed in non-Caucasian races with osteoarthritis (Cisternas et al 2009), findings supported by another study that demonstrated that non-white or minority race was independently associated with lesser of utilisation of allied health services (e.g.…”