The views and perspectives of adults with cerebral palsy about physiotherapy services

Background and Objectives: Adults with cerebral palsy (CP) experience musculoskeletal pain, reduced balance, declines in mobility, falls and fatigue. As a result, they require access to appropriate health services, including physiotherapy, across their lifespan. The ongoing review found that physiotherapy is the most commonly used (44%) rehabilitation services among adults with CP. Qualitative studies suggest that young adults with CP are concerned about the environmental, organisational and interpersonal contexts in which health care services are carried out. However, little is known about the experience of physiotherapy services for people with CP from the perspective of people living with CP in the UK and Ireland. Therefore, this study aims to examine the use and need for physiotherapy services among adults with CP living in the UK and Ireland; and to examine the associations between factors associated with physiotherapy use among adults with CP living in the UK and Ireland.
Methods: A cross-sectional semi-structures online survey was employed. Adults with CP aged 18 and above living in the UK and Ireland; able to complete an online questionnaire in English independently or with assistive devices or via a personal assistant.The recruitment was from social media platforms, and organisations that provided services or support to adults with disability in the UK and Ireland, guided by the advisory group discussions. Data was collected from April 2019 to February 2020 of adults with CP living in UK and Ireland. Descriptive analysis and logistic regression was conducted using STATA 16 to examine association between demographic factors and physiotherapy use..
Results: Participants (n=162) were aged 18-74 years. The majority were female (75%), lived in the UK (83%) and were classified as GMFCS level I (9%), II (38%), III (25%), IV (17%) and V (9%). The GMFCS level was associated with physiotherapy use. Ninety percent of participants reported a need for physiotherapy but only 35% received physiotherapy services. The most common reasons for physiotherapy visits included mobility decline (62%), stiffness (57%), pain (54%) and spasticity management (51%). Additionally, participants were not satisfied with the availability (66%) and quality (54.3%) of physiotherapy services.
Conclusion: Although the majority of adults reporting needing physiotherapy, most of these people did not receive the physiotherapy that they needed. The study findings can inform development of physiotherapy services for adults with CP.