Journal of Cancer Survivorship

, Volume 5, Issue 1, pp 73–81

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

Authors

    • Capstone College of NursingUniversity of Alabama
  • Sujuan Huang
    • Department of Epidemiology and Cancer ControlSt. Jude Children’s Research Hospital
  • Cheryl L. Cox
    • Department of Epidemiology and Cancer ControlSt. Jude Children’s Research Hospital
  • Wendy M. Leisenring
    • Clinical Research DivisionFred Hutchinson Cancer Research Center
  • Kevin C. Oeffinger
    • Department of PediatricsMemorial Sloan Kettering Cancer Center
  • Melissa M. Hudson
    • Department of OncologySt. Jude Children’s Research Hospital
  • Jill Ginsberg
    • Division of OncologyChildren’s Hospital of Philadelphia
  • Gregory T. Armstrong
    • Department of Epidemiology and Cancer ControlSt. Jude Children’s Research Hospital
  • Leslie L. Robison
    • Department of Epidemiology and Cancer ControlSt. Jude Children’s Research Hospital
  • Kirsten K. Ness
    • Department of Epidemiology and Cancer ControlSt. Jude Children’s Research Hospital
Article

DOI: 10.1007/s11764-010-0151-9

Cite this article as:
Montgomery, M., Huang, S., Cox, C.L. et al. J Cancer Surviv (2011) 5: 73. doi:10.1007/s11764-010-0151-9

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.

Methods

The sample included 5+ year survivors from the Childhood Cancer Survivor Study (N = 9,289). Questions addressing use of PT or chiropractic services and HRQL (Medical Outcomes Survey Short Form (SF-36)) were evaluated. Multivariable regression models compared PT and/or chiropractic utilization between survivors and siblings, and by diagnosis, treatment and demographic characteristics; associations between chronic disease, PT/chiropractic use, and HRQL were similarly evaluated.

Results

Survivors were not more likely to use PT (OR 1.0; 95% CI 0.8–1.2) or chiropractic (OR 0.8; 95% CI 0.7–1.0) services than siblings. More survivors reported using chiropractic (12.4%) than PT (9.2%) services. Older age and having health insurance were associated with utilization of either PT or chiropractic services. Grade 3-4 chronic conditions and a CNS tumor or sarcoma history were associated with PT but not with chiropractic service utilization. Survivors with musculoskeletal (OR 1.8; 95% CI 1.1–2.9), neurological (OR 3.4; 95% CI 1.6–6.9), or cardiovascular (OR 3.3; 95% CI 1.6–6.9) chronic conditions who used PT/chiropractic services were more likely to report poor physical health than survivors who did not use services.

Conclusions

The reported prevalence of PT/chiropractic among survivors is consistent with that reported by siblings. Severity of late effects is associated with service use and with reporting poor physical health.

Implications for Cancer Survivors

Long-term childhood cancer survivors do not appear to utilize rehabilitation services to optimize physical function and support increased HRQL.

Keywords

Physical therapyChiropracticChildhood cancer survivorHealth related quality of life

Copyright information

© Springer Science+Business Media, LLC 2010