MSK and Other Comorbid Diagnoses and Use of PT/OT in Adults with CP
Citation: Thorpe D, Gannotti M, Peterson MD, Wang CH, Freburger J. Musculoskeletal diagnoses, comorbidities, and physical and occupational therapy use among older adults with and without cerebral palsy. Disability Health Journal. 2021 Oct;14(4):101109. doi: 10.1016/j.dhjo.2021.101109. PMID: 33933399.
Study type/Population: A 4 year retrospective cohort study of Medicare claims data for adults aged 65 and over living in the community with (n=8796) and without (n=5,613,384) CP, who also had at least one claim for a Musculoskeletal (MSK) diagnosis in the US; comparison of the presence of comorbidities, and patterns of Physical Therapy (PT) and Occupational Therapy (OT) use among those with CP and those without CP.
Key Findings: Adults with CP had higher prevalence of most MSK conditions than those without CP, including soft tissue disorders (87% vs 74%), joint pain (61% vs 58%), and bone/cartilage disorders (50% vs 44%). Across MSK conditions, a low proportion of older adults with CP used PT services (19%); and for those with soft tissue disorders and joint pain, PT use was significantly lower for older adults with CP than for those without CP. Older adults with CP had higher prevalence of congestive heart failure, peripheral vascular disease, paralysis, weight loss, fluid and electrolyte disorders, depression, and psychosis relative to their peers without CP.
Translation to Practice: MSK disorders are frequent in older adults with CP (as are a wide array of comorbidities) and PT is underutilized in this group. To reduce the burden of MSK disorders, pain and comorbidities in adults with CP, clinical screening, early health interventions, and development of efficient referral resources for coordinated care are required.