Journal of Cancer Survivorship

, Volume 5, Issue 1, pp 73–81 | Cite as

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

  • Michele Montgomery
  • Sujuan Huang
  • Cheryl L. Cox
  • Wendy M. Leisenring
  • Kevin C. Oeffinger
  • Melissa M. Hudson
  • Jill Ginsberg
  • Gregory T. Armstrong
  • Leslie L. Robison
  • Kirsten K. Ness



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.


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.


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.


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.


Physical therapy Chiropractic Childhood cancer survivor Health related quality of life 


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Michele Montgomery
    • 1
  • Sujuan Huang
    • 2
  • Cheryl L. Cox
    • 2
  • Wendy M. Leisenring
    • 4
  • Kevin C. Oeffinger
    • 5
  • Melissa M. Hudson
    • 3
  • Jill Ginsberg
    • 6
  • Gregory T. Armstrong
    • 2
  • Leslie L. Robison
    • 2
  • Kirsten K. Ness
    • 2
  1. 1.Capstone College of NursingUniversity of AlabamaTuscaloosaUSA
  2. 2.Department of Epidemiology and Cancer ControlSt. Jude Children’s Research HospitalMemphisUSA
  3. 3.Department of OncologySt. Jude Children’s Research HospitalMemphisUSA
  4. 4.Clinical Research DivisionFred Hutchinson Cancer Research CenterSeattleUSA
  5. 5.Department of PediatricsMemorial Sloan Kettering Cancer CenterNew YorkUSA
  6. 6.Division of OncologyChildren’s Hospital of PhiladelphiaPhiladelphiaUSA

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