Longitudinal Patterns of Postfracture Outpatient Physical Therapy and Occupational Therapy Use and Its Association With 3-Year Mortality Among Adults With Cerebral Palsy

Prepared by Nelleke Langerak

Citation: Gottlieb REW, Panzer KV, Wang M, Leis AM, Whitney DG. Longitudinal Patterns of Postfracture Outpatient Physical Therapy and Occupational Therapy Use and Its Association With 3-Year Mortality Among Adults With Cerebral Palsy. Physical Therapy  2023 Aug; 1;103(8):pzad090. doi: 10.1093/ptj/pzad090.

Study type/population: This retrospective cohort study of 2429 adults with cerebral palsy (CP) from a US dataset, explored physical and/or occupational therapy service use for six months after sustaining a fragility fracture, and any relationship with mortality within the following 3 years.

Key findings: The study identified four distinct participant groups. Group 1 (73% of participants) showed low probability of receiving physical therapy or occupational therapy during the initial six months after the fracture. In contrast, Group 2 (15%) and Group 3 (1%) demonstrated early start of therapy, with variable intensity and maintenance over time. Group 4 (11%) started therapy later, around 7 weeks post-fracture. Over the three-year period the overall mortality rate was 6.7 deaths per 100 person-years, 26% lower for the early start groups (Groups 2 and 3) and 20% lower for the later start group (Group 4).

Translation to practice: Only one in four adults with CP used physical therapy and/or occupational therapy within six months of a fragility fracture. Individuals utilizing these services, irrespective of whether they started therapy early or later, exhibited better survival rates within three years after the fracture, particularly for those with less medical complexity. This highlights the importance of accessibility to and the provision of rehabilitation services to maximise health and function.