title: Use of physical therapy services among middle-aged and older adults with multiple sclerosis.
abstract: BACKGROUND
  There is limited understanding of the utilization of and perceived need for physical therapy services among middle-aged and older adults with multiple sclerosis (MS). The resulting knowledge gap compromises efforts for physical therapy service planning for this population.
  
  
  OBJECTIVE
  The purpose of this study was to examine the use of and need for physical therapy services in a sample of adults with MS living in the Midwestern United States.
  
  
  METHODS
  This was a cross-sectional, descriptive study.
  
  
  METHODS
  Data from telephone interviews with 1,065 people with MS, aged 45 to 90 years, were used for the study. A multinomial regression model was used to determine factors associated with use of physical therapy services (never, within the past year, more than a year ago). Logistic regression analysis examined factors associated with unmet needs for these services.
  
  
  RESULTS
  Thirty-six percent of the sample reported never using physical therapy services, 33% reported using physical therapy services within the past year, and 31% reported using physical therapy services more than a year prior to the interview. Factors associated with recent use of physical therapy services included living in an urban or suburban community, deteriorating MS status, experiencing problems with spasticity (ie, hypertonicity), having difficulty moving inside the house, being hospitalized in the past 6 months, and seeing a family physician. These same factors were associated with unmet needs. Limitations Physical therapy service use was self-reported. Data were collected in 5 Midwestern states from people 45 years of age or older, which may limit generalizability.
  
  
  CONCLUSIONS
  Factors associated with use of and need for physical therapy services reflect issues of access (geographical, referrals), MS status, and mobility difficulties.
authors.affiliation: Department of Occupational Therapy, University of Illinois at Chicago, 1919 W Taylor St (MC 811), Chicago, IL 60612, USA. marciaf@uic.edu
authors.forename: Marcia
authors.initials: M
authors.lastname: Finlayson
authors.forename: Matthew
authors.initials: M
authors.lastname: Plow
authors.forename: Chi
authors.initials: C
authors.lastname: Cho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand; D006760:Hospitalization; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D051346:Mobility Limitation; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000628:therapy*; D009128:Muscle Spasticity / Q000453:epidemiology; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D010821:Physicians, Family; D012720:Severity of Illness Index; D013383:Suburban Population; D014505:Urban Population