Benjamin C Conner1, Tao Xu2, Neil S Kamdar3, Heidi Haapala4, Daniel G Whitney5. 1. College of Medicine - Phoenix, University of Arizona, Phoenix, AZ, USA. 2. Kidney Epidemiology and Cost Center, School of Public Health, University of Michigan, Ann Arbor, USA. 3. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, USA; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, USA; Department of Surgery, University of Michigan, Ann Arbor, USA; Department of Emergency Medicine, University of Michigan, Ann Arbor, USA. 4. Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, USA. 5. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, USA; Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, USA. Electronic address: dgwhit@umich.edu.
Abstract
BACKGROUND: Adults with cerebral palsy (CP) experience functional declines. Clinical rehabilitation may preserve function for this population. OBJECTIVE: To identify longitudinal physical/occupational therapy use and associated factors among adults with CP, to inform health promotion strategies. METHODS: A retrospective cohort study including adults ≥ 18 years of age with CP was performed using a random 20% Medicare fee-for-service dataset. Participants with continuous medicare enrolment from 01/01/2016-12/31/2018 were included: 2016 was the one-year baseline period; 2017-2018 was the two-year follow-up. Therapy included an indication of physical, occupational, or other forms of therapy. Two-year therapy use patterns were identified using group-based trajectory modeling. Multivariable multinomial logistic regression models identified associations between baseline characteristics with trajectory groups. RESULTS: Of 17,441, 7231 (41.5%) adults with CP had therapy use across the three-year period, and six longitudinal therapy trajectories were identified: the majority (42.5%) were low-consistent users, 13.4% moderate-consistent users, 4.4% high-consistent users, and the remaining variable users. Associations between baseline characteristics (e.g., age, sex, comorbidities) with trajectory groups varied. For example, using the low-consistent users as the reference, Black versus White were 49% less likely, Northeast versus South residency were 7.52-fold more likely, and co-occurring neurologic conditions versus CP only were up to 118% more likely to be high-consistent users (all, P < 0.05). Bone fragility and some chronic comorbidities were associated with moderate consistent users. CONCLUSIONS: The majority of adults with CP were not using physical/occupational therapy. Of those that did, there were unique longitudinal trajectories which associated differently with demographics and comorbidities.
BACKGROUND: Adults with cerebral palsy (CP) experience functional declines. Clinical rehabilitation may preserve function for this population. OBJECTIVE: To identify longitudinal physical/occupational therapy use and associated factors among adults with CP, to inform health promotion strategies. METHODS: A retrospective cohort study including adults ≥ 18 years of age with CP was performed using a random 20% Medicare fee-for-service dataset. Participants with continuous medicare enrolment from 01/01/2016-12/31/2018 were included: 2016 was the one-year baseline period; 2017-2018 was the two-year follow-up. Therapy included an indication of physical, occupational, or other forms of therapy. Two-year therapy use patterns were identified using group-based trajectory modeling. Multivariable multinomial logistic regression models identified associations between baseline characteristics with trajectory groups. RESULTS: Of 17,441, 7231 (41.5%) adults with CP had therapy use across the three-year period, and six longitudinal therapy trajectories were identified: the majority (42.5%) were low-consistent users, 13.4% moderate-consistent users, 4.4% high-consistent users, and the remaining variable users. Associations between baseline characteristics (e.g., age, sex, comorbidities) with trajectory groups varied. For example, using the low-consistent users as the reference, Black versus White were 49% less likely, Northeast versus South residency were 7.52-fold more likely, and co-occurring neurologic conditions versus CP only were up to 118% more likely to be high-consistent users (all, P < 0.05). Bone fragility and some chronic comorbidities were associated with moderate consistent users. CONCLUSIONS: The majority of adults with CP were not using physical/occupational therapy. Of those that did, there were unique longitudinal trajectories which associated differently with demographics and comorbidities.
Authors: Adam T C Booth; Annemieke I Buizer; Pieter Meyns; Irene L B Oude Lansink; Frans Steenbrink; Marjolein M van der Krogt Journal: Dev Med Child Neurol Date: 2018-03-07 Impact factor: 5.449
Authors: H Kerr Graham; Peter Rosenbaum; Nigel Paneth; Bernard Dan; Jean-Pierre Lin; Diane L Damiano; Jules G Becher; Deborah Gaebler-Spira; Allan Colver; Dinah S Reddihough; Kylie E Crompton; Richard L Lieber Journal: Nat Rev Dis Primers Date: 2016-01-07 Impact factor: 52.329
Authors: Daniel G Whitney; Tao Xu; Daniel Whibley; Dayna Ryan; Michelle S Caird; Edward A Hurvitz; Heidi Haapala Journal: J Clin Med Date: 2022-09-22 Impact factor: 4.964