Occupational injuries of physiotherapists in North and Central Queensland

A systematic review of work related musculoskeletal disorders among physical therapists and physiotherapists

Physical therapists and physiotherapists (PPTs) perform and repeat physical tasks that can lead to work-related musculoskeletal disorders (WMSD). The aim was to study the main research concerning this problem, i.e. the risk factors, activities that exacerbate WMSD symptoms, alterations in work habits and the proposed responses, and to estimate mean value (±standard deviation, STD) for the most studied parameters. This review was conducted according to the PRISMA guideline. Five databases (Pubmed, ScienceDirect, Google Scholar, Medeley and Science.gov) were scanned to identify works investigating the different aspects of WMSD among PPTs. Two reviewers independently selected relevant studies using inclusion/exclusion criteria, critically appraised, and extracted data. To homogenize the data, prevalence were reported to the total sample studied when necessary. Among the 9846 articles identified, 19 articles were included. The WMSD prevalence was over 50 %. The areas most affected were the lower back, neck and thumb. An exhaustive list of parameters were constructed for job risk factors (n = 19), activities that exacerbating symptoms (n = 13), altered work habits (n = 15), responses and treatments (n = 26). The mean prevalence (±STD) was calculated for the major parameters. Nine main job risk factors were extracted with an average prevalence of about 30 % and a relatively high variability. Seven activities exacerbating WMSD symptoms and five altered work habits were identified with a homogeneous rate (5-20 %). Three main responses and treatments were found with heterogeneous prevalence. This review provides useful results for the development of future protocols to prevent the occurrence of WMSD among PPTs and meta-analyses.

Clinical tests predictive of temporary low back pain development during the prolonged standing test in physical therapy students

Low back pain among physical therapists is a common musculoskeletal disorder that first occurs early in their career or as a student. This observational prospective study assessed the ability of hip and lumbopelvic neuromuscular control, endurance and hip range of motion tests to predict the development of transient low back pain development during a standing task. Seventy-two physical therapy students without low back pain completed nine performance tests and a 2-hour standing test on two separate days. Participants were classified as transient pain developers (PD) if they reported a ≥ 10mm increase in low back pain on a visual analog scale. Transient back pain was reported by 37.5% of students during the standing test. A cluster of three positive tests, self-rated active hip abduction (somewhat difficult or more), bilateral total hip internal rotation greater than 81 degrees, and non-dominant limb single-leg squat (moderate deviations), demonstrated an increased probability (94.9%) of identifying PDs. Negative findings on the same three tests decreased the probability to 10.7%. Overall, the classification accuracy for the three-test model was 72.2%. The sensitivity for the model was 63% and the specificity was 77.8%.

Work-Related Musculoskeletal Disorders Risk Assessment during Manual Lymphatic Drainage with Compressive Bands among Physiotherapists

BACKGROUND

Complete decongestive therapy is the standard treatment for lymphedema. Manual lymphatic drainage and short-stretch multilayer compression bandaging are two daily stages of complete decongestive therapy during which physiotherapists work with patients.

OBJECTIVE

The aim of this study was to assess the risks of musculoskeletal disorders to which physiotherapists are exposed during these two phases.

METHOD

Five physiotherapists performed five 20 min manual lymphatic drainages, followed by the compression bandaging phase. From the video recordings, 8477 postures defined by 13 joint angles were grouped into clusters using hierarchical cluster analysis. The risk of musculoskeletal disorders in physiotherapists' postures was assessed using ergonomic tools.

RESULTS

Seven clusters, called generic postures (GP), were identified and defined throughout the mean joint angle values and standard deviation. Four seated GPs were found for the drainage phase, and three standing GPs were identified for the bandaging phase. This phase corresponded to a quarter of the total duration. The GP's ergonomic scores ranged from 4.51 to 5.63 and from 5.08 to 7.12, respectively, for the Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA). GP1, GP3, and GP4 presented the highest ergonomic scores (RULA scores: 5.27 to 5.63; REBA scores: 6.25 to 7.12). The most affected areas were the neck (flexion > 20° for all GPs), trunk (flexion between 25 and 30° for GP2, and GP7 during the bandaging phase and GP4 during the drainage phase), and shoulder (flexion and abduction >20° for all GPs except GP5).

CONCLUSIONS

These results highlighted that the two complete decongestive therapy phases could be described as a combination of GP. Ergonomic assessment showed that compression bandaging as well as drainage phases expose physiotherapists to moderate musculoskeletal disorder risks that require "further investigation and change soon".

Prevalence and risk factors of work-related musculoskeletal disorders among physical therapists in Ho Chi Minh City, Vietnam

BACKGROUND

Understanding risk factors linked to work-related musculoskeletal disorders (WMSDs) is crucial for enhancing health promotion and ensuring workplace safety among healthcare professionals particularly physical therapists (PTs). However, in Vietnam, there has been lack of an investigation. Therefore, this study was to determine whether potential risk factors contributed to the occurrence of WMSDs among PTs in Ho Chi Minh City.

METHOD

An online self-reported questionnaire for WMSDs comprising the Nordic Musculoskeletal Questionnaire (NMQ), Job-risk and Environmental factors, the Perceived Stress Scale (PSS-4) and the coping strategies, were distributed to PTs. They were enrolled if they had: age ≥ 22 years, graduated from PT program, a full-time job with ≥1 year of experience. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were determined using Logistic regression.

RESULTS

Our study found that within the past 12 months, the prevalence of WMSDs was 76.4% (n = 204/267): neck 58.4% and lower back 57.3%. PTs aged 22-29 years, < 4 years of education, and < 7 years of working experience were more likely to have WMSDs 2-3 times than those who did not. After adjusting for age, education, and work experience, PTs who engaged in manual techniques/exercises, lifting/transferring patients, and maintaining awkward postures were 5-7 times more likely to have WMSDs in the neck and lower back than those who did not. Environmental and psychological factors, such as number of treatment tables, size of electrotherapy rooms, using PTs modalities, and stress were significantly associated with WMSDs. More than 50% of PTs used modified positions and new treatment/techniques that did not aggravate their symptoms, as coping strategies.

CONCLUSIONS

This study indicates potential risk factors associated with WMSDs, affecting the neck and lower back among PTs in Vietnam. These risk factors should be addressed to improve overall PTs health, retain skilled workers, and encourage them to continue working.

Sharps injuries within the healthcare student population: a narrative review

BACKGROUND

Studies have reported evidence on sharps injuries among nursing, medical and dental students but little is known about the amount, type and causes of sharps injuries affecting other healthcare students.

AIM

The aim of the narrative review was to identify the extent, type and causes of sharps injuries sustained by healthcare students, especially those not in those fields.

METHOD

Eight databases were searched using keywords to identify studies published between 1980 and March 2023.

FINDINGS

This narrative review highlights that some groups of healthcare students, including those studying pharmacy, physiotherapy and radiography, sustain sharps injuries from similar devices as reported in research on such injuries in nursing, medical and nursing students. Sharps injuries happen in a range of healthcare environments, and many were not reported by students. The main cause of a sharps injury identified was a lack of knowledge.

CONCLUSION

More research is needed on the extent of sharps injuries in healthcare students in European countries and the UK as well as on their physical and psychological effects. Education and training in sharps use and disposal are essential.

Prevalence of work-related musculoskeletal hand and wrist disorders in physiotherapists

OBJECTIVES

This study examines the prevalence of hand and wrist symptoms and diagnosed disorders in physiotherapists in Slovakia. The aim was to identify risk factors such as occupational settings type, number of patients treated per day and years of clinical practice, and to determine preferred methods of treatment.

METHOD

The group of 107 physiotherapists (28 men and 79 women) participated in the study. All participants completed a questionnaire created for the purpose. It contained demographic data, years of clinical practice and the questions to determine the presence of various symptoms and injuries to the hand and wrist due to a long-lasting overuse of the hand musculoskeletal system.

RESULTS

Twelve (11.2%) physiotherapists of the observed group did not show any symptoms of functional impairment, and 32 (29.9%) were without any specific hand or wrist disorders. The results confirmed a significant prevalence of symptoms of functional impairment (mean 2.4) and disorders (mean 1.3) with an increased risk in the physiotherapists working in a combined type of occupational settings (outpatient physical therapy and hospital facilities). The most frequently reported symptoms were hand pain (70%) and reduced muscle strength (45.7%). The most frequently reported diagnosed disorder was hand tendonitis (26.2%). The results confirmed the statistically significant correlation (α = 0.05) between the years of clinical practice and the number of identified symptoms and disorders (p < 0.001) as well as between the number of patients treated per day and the number of symptoms (p = 0.007). Hand immobilization (28.6%) and manual therapy (24.4%) were preferred methods of treatment. Surgical intervention was required in 2.2% of hand injuries.

CONCLUSIONS

In physiotherapists, long-term performance of manual techniques indicates the development of musculoskeletal disorders of the hand and wrist.

Global prevalence of musculoskeletal disorders among physiotherapists: a systematic review and meta-analysis

BACKGROUND

Musculoskeletal disorders (MSD) are one of the most important problems among physiotherapists worldwide. However, there is no meta-analysis of the MSD prevalence in all body areas among physiotherapists.

OBJECTIVES

The purpose was to investigate and estimate the worldwide prevalence of MSD among physiotherapists using a systematic review-, meta-analysis and meta-regression.

METHODS

The systematic review, meta-analysis and meta-regression were performed in 2022 using the PRISMA guidelines.

DATA SOURCES

The search was performed on PubMed/Medline, ScienceDirect, Google Scholar, Medeley and Science.gov databases.

STUDY APPRAISAL

The quality appraisal of the included articles was assessed using the critical appraisal tool for cross-sectional studies AXIS.

RESULTS

A total of 722 articles were found. After screening and comparison with the inclusion criteria, 26 studies were retained. Based on the random-effects model, the worldwide MSD prevalence in neck, upper back, mid back, lower back, shoulders, elbows, wrists/hands, thumb, hips/thighs, knees/legs, and ankles/feet was 26.4% (CI 95%: 21.0-31.9%), 17.7% (CI 95%: 13.2-22.2%), 14.9% (CI 95%: 7.7-22.1%), 40.1% (CI 95%: 32.2-48.0%), 20.8% (CI 95%: 16.5-25.1), 7.0% (CI 95%: 5.2-8.9), 18.1% (CI 95%: 14.7-21.5%), 35.4% (CI 95%: 23.0-47.8), 7.0% (CI 95%: 5.2-8.8), 13.0% (CI 95%: 10.3-15.8), and 5% (CI 95%: 4.0-6.9) respectively. The neck and shoulder prevalence of four continents were close to the world prevalence. No effect of continent was found on MSD prevalence. The heterogeneity of the results obtained in the meta-analysis and meta-regression was discussed.

CONCLUSIONS

Based on the random effects model, the results of the worldwide meta-analysis showed that lower back pain, thumb, neck and shoulder were the area most at risk for MSD and were therefore those to be monitored as a priority. Recommendations were proposed for future reviews and meta-analyses.

Work-Related, Non-Specific Low Back Pain among Physiotherapists in France: Prevalence and Biomechanical and Psychosocial Risk Factors, as a Function of Practice Pattern

BACKGROUND

Physiotherapists worldwide experience lower back pain (LBP). Up to 80% of physiotherapists report having experienced an episode of LBP at some point in their career, and LBP is the most common musculoskeletal disorder in this profession. In France, the prevalence of LBP among physiotherapists and associated work-related risk factors have not previously been studied.

OBJECTIVE

To determine whether the risk of work-related non-specific LBP among French physiotherapists depends on practice pattern.

METHOD

A link to an online self-questionnaire was sent to French physiotherapists. The various practice patterns were compared with regard to the prevalence of LBP, the total number of days with LBP during the previous 12 months, and the degree of exposure to biomechanical, psychosocial and organisational risk factors.

RESULTS

Among the 604 physiotherapists included in the study, the prevalence of work-related, non-specific LBP in the previous 12 months was 40.4%. The prevalence was significantly greater among physiotherapists working in geriatrics (p = 0.033) and significantly lower in sports medicine (p = 0.010). Differences in exposure to risk factors were also found.

CONCLUSIONS

The risk of non-specific LBP among French physiotherapists appears to depend on the mode of practice. All the various dimensions of risk must be taken into account. The present study could serve as a basis for more targeted research on the most exposed practices.

Neck Disability Index Detects Higher Neck-Related Disability Levels among Physiotherapists and Family Medicine Specialists than among Dentists

BACKGROUND

Healthcare workers who are in physical contact with patients are prone to work-related musculoskeletal disorders (WMSDs). Much is known about the prevalence of neck pain, but the extent of disability associated with neck pain among physical therapists (PTs), dentists, and family medicine specialists (FMs) is unknown.

METHODS

The prevalence of neck pain and Neck Disability Index (NDI) data were collected from 239 PTs, 103 FMs, 113 dentists, and 112 controls from June to August 2022.

RESULTS

The highest prevalence of neck pain was found in FMs (58.3%), followed by dentists (50.4%), PTs (48.5%) and controls (34.8%). The NDI% in PTs and FMs had higher values than controls: 14.6 ± 12.4, p = 0.02 for PTs, 14.9 ± 12.4, p = 0.01 for FMs vs. 10.1 ± 10.1 controls. The dentist group did not differ from controls (11.9 ± 10.2, p = 0.13). Mild, moderate, or severe forms of disability were more common in medical professionals than in controls (44.2%, 9.5%, and 1.5% vs. 37.5%, 7%, and 0%). Dentists were the youngest group with high functionality and the lowest degree of disability, comparable to the control population. Gender or age had no effect on NDI scores in this population. FMs, who represented the oldest group, showed age dependency (eleven years older in higher disability groups). Gender had no effect on NDI. In PTs, females predominated in all disability categories and PTs became five years older with increasing disability level.

CONCLUSION

By using NDI in assessing neck-related WMSDs, we can detect medical professionals prone to more serious disability and potentially plan preventive actions.

Ergonomic risk assessment during massage among physiotherapists: Introduction of generic postures notion

BACKGROUND

Musculoskeletal disorders are prevalent among physiotherapists. They perform many repetitive tasks in awkward postures that require a high muscle load. This issue was often addressed through subjective analysis (questionnaire) but rarely using postural evaluation combined with an ergonomic assessment.

OBJECTIVE

The aim of this article was to decompose draining lymphatic massage performed by physiotherapists in generic postures (GP) to quickly assess the musculoskeletal disorder risk.

METHODS

Based on numeric video recorded in frontal and sagittal planes, 3360 postures were defined from 20-minutes lymphatic drainage massage performed by 7 physiotherapists over a period of 6 months. A hierarchical cluster analysis was applied to define the GP.

RESULTS

Seven GP were identified, which were described by their average joint angles, variability and relative frequency. GP6, GP4 and GP2 had the highest frequencies (17.6%, 16.9% and 16.8% respectively). Trunk and neck were essentially flexed (neck: 17.0±10.0° for GP1; trunk: 20.4±8.7° for GP4). Shoulder flexion and abduction ranged from 15° (GP7) to 60° (GP4). Mean and variability of RULA score completed the analysis. The highest scores were computed for GP2 and GP3 (respectively 5.5±1.3 and 5.8±1.2, p < 0.05). GP4 had the lowest (4.0±1.1, p < 0.05). The results suggest that massages have to be monitored. Attention should be paid to the postures used to prevent the occurrence of MSDs.

CONCLUSION

The massages could be described as a combination of generic posture for a rapid ergonomic assessment.

Prevalence of Body Area Work-Related Musculoskeletal Disorders among Healthcare Professionals: A Systematic Review

Healthcare professionals perform daily activities that can lead to musculoskeletal disorders (MSDs). The objective of this review was to summarize these MSDs by body areas in relation to healthcare professions. The underlying question is, worldwide, whether there are areas that are more exposed depending on the occupation or whether there are common areas that are highly exposed to MSDs. This issue has been extended to risk factors and responses to reduce MSDs. The review was conducted according to the PRISMA guidelines between February and May 2022. Google scholar and Science Direct databases were scanned to identify relevant studies. Two authors independently reviewed, critically appraised, and extracted data from these studies. Overall and body area prevalence, risk factors, and responses to MSDs were synthetized by occupational activity. Among the 21,766 records identified, 36 covering six healthcare professions were included. The lower back, neck, shoulder and hand/wrist were the most exposed areas for all healthcare professionals. Surgeons and dentists presented the highest prevalence of lower back (>60%), shoulder and upper extremity (35-55%) MSDs. The highest prevalence of MSDs in the lower limbs was found for nurses (>25%). The main causes reported for all healthcare professionals were maintenance and repetition of awkward postures, and the main responses were to modify these postures. Trends by continent seem to emerge regarding the prevalence of MSDs by healthcare profession. Africa and Europe showed prevalence three times higher than Asia and America for lower back MSDs among physiotherapists. African and Asian nurses presented rates three times higher for elbow MSDs than Oceanians. It becomes necessary to objectively evaluate postures and their level of risk using ergonomic tools, as well as to adapt the work environment to reduce exposure to MSDs with regard to the specificities of each profession.

Employment-related musculoskeletal complications experienced by the physical therapists in Bangladesh: a comprehensive cross-sectional case study

Background

Dentists, nurses, and physical therapists have all been associated with an increased risk of work-related diseases. The findings of studies in these different occupations might aid in the development of preventative measures. In Bangladesh, however, no comparable evidence has been recorded among physical therapists. The study’s goal was to find out the prevalence of work-related physical problems at different anatomical locations, as well as the link between these disorders and treatment strategies across Bangladeshi physical therapists.

Methods

A physical and online survey of Bangladeshi physical therapists was done. A total of 300 questionnaires were given out, with work-related discomfort or pain detected in nine locations of the body: (1) neck, (2) shoulder, (3) elbow, (4) wrists, (5) upper back, (6) lumbar, (7) thighs, (8) knee, and (9) ankle.

Results

85.5% of Bangladeshi physical therapists suffer musculoskeletal problems, according to the results of this research. The neck (25.7%), lower back (15.2%), elbow (12.3%), ankle (8.6%), and shoulder (8.6%) were the most often affected locations (7.1%). Upper back (3.0%) and hips (2.2%) ailments had the lowest prevalence.

Conclusion

Work-related musculoskeletal illnesses were common among the Bangladeshi physical therapists, especially in their neck, lower back, elbow, and ankle regions.

The Use of Instrument-Assisted Soft-Tissue Mobilization for Manual Medicine: Aiding Hand Health in Clinical Practice

Instrument-assisted soft-tissue mobilization (IASTM) represents a treatment strategy for soft tissue (skin) and musculoskeletal tissue (myofascia). There are different morphologies of these tools that are used by clinicians and manual therapists for the management of scars, fibrotic formations, muscle-joint pain, and movement limitations. The literature demonstrates the effectiveness of IASTMs in different clinical areas. However, the literature does not consider the use of these tools for the protection of the clinician’s hands. The main objective of this article is to draw attention to the fact that IASTM can protect clinicians from professional joint injuries of the hands and can likely become a preventive tool for the operator. Further research is needed to fully determine the positive adaptations in operators who use IASTMs compared to those who do not use them.

Work-related musculoskeletal disorders among jordanian physiotherapists: Prevalence and risk factors

BACKGROUND: Musculoskeletal complaints associated with work are common health problems among physiotherapists due overload exposure and unsuitable postures. OBJECTIVE: To assess work-related musculoskeletal disorders (WMSDs) among Jordanian physiotherapists and investigate the factors that might increase the risk of having WMSDs among physiotherapists by using the ICF model as a guiding framework. METHODS: A cross-sectional study was conducted on 139 physiotherapists. Participants’ ages ranged from 23 to 61 years with 53.2% who identified as female. To assess WMSDs the Quick Exposure Check was used. Furthermore, depression, sleep, social support and job satisfaction were all assessed using Beck Depression Inventory, Pittsburgh Sleep Quality Index, Multidimensional Scale of Perceived Social Support, and Minnesota Satisfaction Questionnaire, respectively. Furthermore, age, gender, body mass index (BMI), educational level, smoking status and marital status were also collected from all participants. RESULTS: The results showed that the most common musculoskeletal complaints were as follows: 100% of the participants reported overload occurrence in the cervical spine, 97.9% in the lumbar spine, 96.5% in the shoulder joint, and 24.1% in the wrist joint. There was a significant negative correlation between total exposure and gender. Also, total exposure was significantly and positively correlated with BMI and the Minnesota Satisfaction Questionnaire (MSQ). CONCLUSION: This study suggest a need to increased knowledge of self-protection strategies among physiotherapists to reduce the occurrence of musculoskeletal disorders. Understanding the factors that might increase WMSDs is useful for future research, quality improvement, and educational programs to reduce the rates of WMSDs among physiotherapists.

Prevalence of and prevention for work-related upper limb disorders among physical therapists: a systematic review

Background

Physical therapists (PTs) are at increased risk for development of work-related upper limb disorders (WRULDs) due to the physically intensive, constant hands-on nature of the profession. The objectives of this systematic review were to examine the literature on WRULDs among PTs, specifically the (1) 1-year prevalence, (2) workplace risk factors, (3) consequences, and (4) coping strategies utilized to mitigate WRULDs.

Methods

A comprehensive search of the literature was performed using PubMed, CINHAL, EMBASE, and Google Scholar. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for conducting this systematic review. Studies that reported the 1-year prevalence of WRULDs among PTs, workplace risk factors for WRULDs, consequences of WRULDs, and coping strategies utilized by PTs were included.

Results

Twelve studies met the inclusion criteria. The 1-year WRULDs prevalence rates varied widely, with thumb disorders having the highest prevalence (7.6-52.5%), followed by wrist and hand disorders (5-66.2%), shoulder disorders (3.2-45.2%), and elbow disorders (4-16%). Reported risk factors included treating a high volume of patients and frequent performance of manual therapy techniques. Consequences included interference with PTs’ personal and professional activities while coping strategies involved alterations to the work environment, techniques used, and workload.

Conclusions

WRULDs remain a persistent threat to the PT workforce, likely due to the hands-on, physically intensive nature of professional activities. An essential strategy to reduce WRULDs is to improve clinicians’ awareness of WRULDs, workplace risk factors, and subsequent consequences of WRULDs. Effective coping strategies are critical to preserve, protect, and prolong PTs’ use of the upper limbs.

Work-related musculoskeletal disorders among physical therapists in Taiwan

Work-related musculoskeletal disorders (WMSD) refer to musculoskeletal injuries caused by the occupation. Physical therapists (PTs) suffer from a high risk of WMSD despite their extensive knowledge in ergometrics and injury prevention. This study aims to discover the incidence and prevalence of WMSD among PTs using Taiwan's nationwide claims database. The trend of annual patients seeking rehabilitation and the prevalence of WMSD among PTs were presented. The age- and gender-specific incidence of WMSD were also calculated. The prevalence of WMSD in PTs varied from 6.1% to 75.2%, and the incidence ranged from 6.1 to 29.1 per 100 person-years during 1997 and 2012. For those aged ≤30 years, the incidence was higher in females than males (incidence rate ratio  = 1.08, 95% confidence interval [CI]: 1.02-1.14, P = .011), whereas for those aged from 31 to40 years, females had lower incidence of WMSD than males (incidence rate ratio  = 0.88, 95% CI: 0.80-0.96, P = .007). The patients/PTs ratio was higher (270.56-337.74) in 1998 and 2004 to 2007 and became stable (245.93-252.82) in 2008 to 2012, correlating with a rise in the WMSD prevalence in 1999 to 2007 and a steady prevalence after 2008 (63.5%-66.3%) in PTs. In conclusion, the risk of WMSD among PTs was positively correlated to the frequency of patients seeking rehabilitation service. In addition, age and gender were important risk factors for developing WMSD among PTs.

Simultaneous measurement of centre of pressure and centre of mass in assessing postural sway in healthcare workers with non-specific back pain: protocol for a cross-sectional study

INTRODUCTION

Low back pain (LBP) is widely prevalent in healthcare workers. It is associated with impaired postural and core stability. So far, centre of pressure (CoP) measures have been commonly recorded through the use of a force plate in order to assess postural stability. However, this approach provides limited information about the centre of mass (CoM) movement in the lumbar region in individuals with LBP. Recent developments in sensor technology enable measurement of the trunk motion which could provide additional information on postural sway. However, the question remains as to whether CoM measures would be more sensitive in discriminating individuals with mild and moderate back pain than traditional CoP analyses. This study aims to investigate the sensitivity of CoP and CoM measures under varied stable, metastable and unstable testing conditions in healthcare workers, and their relationship with the level of subjective reported back pain.

METHODS AND ANALYSIS

This is a cross-sectional controlled laboratory study. A group of 90 healthcare professionals will be recruited from rehabilitation centres within local areas. Participants will complete the Oswestry Disability Questionnaire. The primary outcome will be the rate of their back pain on the 0-10 Low Back Pain Scale (1-3 mild pain and 4-6 moderate pain). Secondary outcomes will include variables of postural and core stability testing during bipedal and one-legged stance on a force plate, a foam mat placed on the force plate, and a spring-supported platform with either eyes open or eyes closed. Both CoP using the posturography system based on a force plate and CoM using the inertial sensor system placed on the trunk will be simultaneously measured.

ETHICS AND DISSEMINATION

Projects were approved by the ethics committee of the Faculty of Physical Education and Sport, Comenius University in Bratislava (Nos. 4/2017, 1/2020). Findings will be published in peer-reviewed journals and presented at conferences.

Work-related musculoskeletal disorders among Egyptian physical therapists

Background

Physical therapists (PTs) are frequently exposed to work-related musculoskeletal disorders (WMSDs). There is limited evidence on the prevalence of these injuries and their potential risk factors in Egyptian PTs. This study aimed at estimating the prevalence of WMSDs among Egyptian PTs as well as potential risk factors and therapists’ coping strategies. Further, it investigated the association between WMSDs and socioeconomic factors.

Results

Three hundred eighty-five eligible participants completed a survey. The prevalence of WMSDs was 99.5%. The five top affected anatomic regions were lower back (69.1%), neck (65.7%), shoulder (47.7%), wrist/hand (39.1%), and upper back (37.0%). Therapists rated awkward positions and handling of heavy patients as the most common predisposing factors for sustaining injuries. Regarding coping strategies, seeking informal help from peers to treat injuries-related symptoms and changing the posture of therapists and patients while working were mostly used by PTs. Overall, female therapists had higher injury prevalence than males (Cramer’s V < 0.5, p ≤ 0.05); except for upper back (p > 0.05). Education and working in multiple facilities simultaneously (public and private clinics) correlated significantly to sustaining injuries in the upper back (V = 0.14, p = 0.049 and V = 0.178, p = 0.002, respectively) and neck (V = 0.16, p = .019 and V = 0.142, p = 0.020, respectively). WMSDs were not associated with therapists’ experience or specialty (p > 0.05).

Conclusion

WMSDs injuries in PTs are prevalent in Egypt, especially in females, therapists with lower academic education, and those working in multiple facilities simultaneously.

Frequency of examination and perceived contribution of factors relating to work-related musculoskeletal disorders of physiotherapists

Objective. Literature confirms that many physiotherapists suffer from work-related musculoskeletal disorders (WMSDs), but studies mention different, complementary and contradictory findings regarding risk factors. This scoping review aimed at revealing the most frequently examined and contributory WMSD factors mentioned in recent studies about physiotherapists. Methods. Based on specific inclusion/exclusion and appraisal criteria, 11 studies published between 2012 and 2018 were included in the analysis. The factors recorded per publication were grouped into 18 categories, the frequency of their appearance across the sources was counted and the median ranks of their relative reported contribution were calculated. Results. Excessive workload was found to be the most contributory factor, followed by the application of manual orthopaedic techniques. However, demanding and repetitive manual tasks were the most common factors investigated in the publications reviewed. A medium-strength correlation was found between the frequency of examination and reported contribution of factors but with a noticeable range of the confidence interval possibly due to the diversity of the approaches in the studies reviewed. Conclusions. The findings indicate a relative discordance between the level of contribution of each factor to the development of WMSDs and the types of factors most frequently addressed by studies.

The Effect of the Powerball Gyroscope as a Treatment Device for Nonspecific Wrist Pain

OBJECTIVE

The aim of this study was to determine the effect of using the Powerball gyroscope as a treatment device on pain and change in endurance in nonspecific wrist pain.

METHODS

This study was a within-participants pre- and postintervention study consisting of 40 participants between ages 18 and 35 with an equal male-to-female ratio. The participants used the Powerball gyroscope for 5 minutes per treatment session. Treatment comprised 12 sessions carried out 3 × per week over a 4-week period. Participants completed objective and subjective data before the first, seventh, and 12th sessions. Objective data were recorded using the Jamar dynamometer to measure grip strength. Subjective data were gathered using the Patient-Rated Wrist Evaluation Questionnaire. Participants then used the Powerball gyroscope in the hand with the affected wrist. The Wilcoxon signed rank test and 1-way repeated-measures analysis of variance were used to analyze the changes.

RESULTS

A significant decrease in pain was noted throughout the study, but the most significant changes occurred between the seventh and 12th treatment sessions (P < .01). A significant increase in grip strength was also noted throughout the study, with the greater increase in grip strength occurring during the first 7 treatments (P < .02).

CONCLUSION

The Powerball gyroscope showed a change in outcome regarding nonspecific wrist pain and grip strength.

Musculoskeletal Complaints in Occupational Therapists Compared to the General Population: A Cross-Sectional Study in Germany

Occupational therapists (OTs) are exposed to physical factors at work, which can lead to an increased risk of musculoskeletal disorders. Most studies examining musculoskeletal complaints in OT report that the neck, shoulders, and lower back are most often afflicted. The aim of the present study was to examine the impact of work as an OT (focusing on specific work tasks) on specific musculoskeletal complaints compared to the general working population. A cross-sectional study involving a self-administered standardized questionnaire was conducted from January until October 2015 in Germany. In OT and the comparison group, the highest 12-month prevalence of musculoskeletal disorders were observed for the lower back, the neck, and the shoulders. In contrast, elevated prevalence ratios (PR) were found for OT in the thumbs (PR = 2.7; 95% CI = 1.9-3.8), the wrists (PR = 1.4; 95% CI = 1.1-1.8), and the elbows (PR = 1.5; 95% CI = 1.0-2.2). OTs were particularly exposed to high exertion hand activity and several stressful postures at work. In conclusion, OTs seem to be at risk of developing work-related musculoskeletal complaints in the thumbs, wrists, and elbows. Preventive measures should help to reduce the exposures caused by highly repetitive and forceful hand activities.

Assessing the physiological strain of physical therapists according to work experience: A cross-sectional study

OBJECTIVES

This cross-sectional study aimed to assess the physiological response of physical therapists to compare the physiological workload within three groups of varying work experience and their comparative physiological responses during a 15-min recovery period.

METHODS

Thirty therapists participated in the present study. They were divided into three groups with varying levels of work experience based on the number of years they had been in active employment: 1) Early Career (EC) group = 2-6 years); 2) Mid-Career (MC) group = 7-11 years), and 3) Late career (LC) group = over 11 years). Each group included 10 subjects comprised of both males and females. To conduct the measurements, each therapist treated one hemiplegic patient for 20 min using a passive range of motion protocol and then rested for 15 min. The maximum voluntary contraction on trapezius and deltoid muscles were tested using electromyography before and after treatment. During treatment, the muscle workload, muscle fatigue, and cardiovascular load were measured. The perceived workload was assessed using a subjective workload index (SWI) questionnaire following treatment.

RESULTS

The three work experience groups of physical therapists performed a similar workload. The SWI corresponded well with physiological measurement. The muscle capacity after treatment of the EC group was significantly lower than that of the MC group (p < 0.05). Notably, the right deltoid of the LC group was significantly lower than that of the MC group.

CONCLUSIONS

The physical therapists worked with a moderate, objectified workload. A 15-min rest period brought the cardiovascular load below 30% and lowered fatigue in the right deltoids. This result may indicate a musculoskeletal disorder warning signal for the physical therapists.

Manual therapy for work-related wrist pain in a manual physical therapist

Introduction: The wrist is a common site for work-related musculoskeletal disorders (WMSD) among physical therapists (PTs), often due to manual therapy. There are limited data on management of wrist injury in PTs. The purpose of this case is to describe the management of a PT with wrist pain.Case Description: The patient was a 28-year-old female with a 6-month history of right ulnar-sided wrist pain, aggravated by performing thoracic/lumbar posterior to anterior (PA) glides. The patient reported 7/10 on the Numeric Pain Rating Scale and 6.5/10 on the Patient-Specific Functional Scale (PSFS). Symptoms were reproduced at the lunotriquetral joint.Outcomes: The patient was seen for two visits. Following anterior to posterior non-thrust mobilization at the triquetrum on lunate, the patient improved inability to perform thoracic/lumbar PA glides. The patient was educated on manual therapy modifications, isometrics, and self-mobilization. At 2-month follow-up, the patient reported 0/10 pain, scored 10/10 on the PSFS, and +7 on the Global Rating of Change.Discussion: This case demonstrates the successful use of education, manual therapy, and exercise in the management of a PT with a wrist-related WMSD. Future research should focus on the prevention/treatment of wrist-related WMSDs in PTs who perform manual therapy.

Wrist and hand pain in orthopaedic physical therapists: A mixed-methods study

BACKGROUND

Orthopaedic physical therapists (PTs) who perform manual therapy are at high risk for wrist and hand pain. Studies that examine the magnitude, scope and causes of wrist and hand pain are needed so that prevention programs can be developed.

OBJECTIVES

The objective of this study was to determine the magnitude, scope, and impact of wrist and hand pain in orthopaedic PTs and to identify potential strategies for prevention.

DESIGN

This was a sequential, mixed methods study including quantitative and qualitative components.

METHODS

The quantitative phase consisted of an online survey sent to members of the Academy of Orthopaedic Physical Therapy. The qualitative phase consisted of focus groups with Orthopaedic PTs who had wrist and hand pain.

RESULTS

The survey included 962 PTs and the focus groups included 10 PTs. The one-year prevalence of wrist and hand pain was 75%. Increasing age, decreasing experience, female gender, performing more manual therapy and working more than 40 h per week were associated with an increased risk of moderate to severe wrist and hand pain. Soft-tissue mobilization was the most frequently cited causative factor. The most commonly mentioned strategy for prevention was altering body mechanics and technique. Focus group participants highlighted the importance of managing expectations for manual therapy by patients.

CONCLUSIONS

Formal injury prevention programs for PT students and PTs are urgently needed. These programs should focus on improving body mechanics and technique, attention to workload, careful selection of manual techniques, and managing expectations for manual therapy.

Prevalence, Profile, and Response to Work-Related Musculoskeletal Disorders among Egyptian Physiotherapists

BACKGROUND:

Despite that physiotherapists (PTs) are supposed to have adequate knowledge of musculoskeletal disorders and the different prevention strategies, they are at high risk of developing work-related musculoskeletal disorders (WRMDs).

AIM:

This study aimed to investigate the prevalence, profile, predictors, and response to WRMDs among Egyptian PTs.

METHODS:

A self-administrated questionnaire was distributed either manually or via e-mail to 564 PTs with at least two years of working experience. Questions elicited information about the personal and occupational history of the respondents in addition to the experience of WRMDs in the past two years.

RESULTS:

Four hundred and fourteen respondents (82.6%) reported WRMDs within the last two years, with the lower back as the most common area affected (68.8%). More than half the PTs (54.8%) who sustained a WRMD reported that their injury took place in a private setting. Significant predictors for WRMDs were age (AOR = 0.78; 95% CI = 0.66, 0.91) and number of years of experience in physiotherapy practice (AOR = 1.26; 95% CI = 1.07, 1.49). In response to the injury, about 73.9% of the respondents stated that they did not officially report their injury and 55.8% of them reported losing a half day or more from their work.

CONCLUSION:

The prevalence of WRMDs among Egyptian physiotherapists is high. Despite socioeconomic and cultural differences between Egypt and other countries, our study findings were consistent with the published reports. Further studies are needed to explore the cultural and psychosocial risk factors of WRMDs.

The epidemiology of work-related musculoskeletal injuries among chiropractors in the eThekwini municipality

Background

Chiropractors are a unique group of health care professionals who are at risk for developing work-related musculoskeletal injuries. Diversity of daily practice imposes different physical demands on the chiropractor. This study aimed to determine the prevalence of work-related musculoskeletal injuries in chiropractors in eThekwini municipality and selected risk factors associated with these work-related musculoskeletal injuries.

Methods

The design was a quantitative, cross-sectional, descriptive study utilising a self-administered questionnaire, developed specifically for this research. The questionnaire contained sections on personal and practice demographics, with questions pertaining to the single most severe work-related musculoskeletal injury, as well as the second and third most severe work-related musculoskeletal injury.

Results

A response rate of 64% was obtained (n = 62). The life-time prevalence of work-related musculoskeletal injuries was 69% with a predominance of injuries to the upper extremity (50%) and lower back (28.3%). The hand/wrist was the most common anatomical site of injury (31.5%) followed by the lower back (28.3%). Number of years in practice was considered a risk factor as most injuries occurred within the first five years of practice (41.6%). The majority of injuries affected the soft tissue, including ligament sprains (27.5%) and muscle strains (26.6%) and occurred while the practitioner was performing manipulation (38.2%) of the lumbosacral (80.8%) area with the patient in the side posture (61.5%).

Conclusions

The results concur with other studies on work-related musculoskeletal injuries in chiropractors and add insight into risk factors predisposing this population to injury.

Electronic supplementary material

The online version of this article (10.1186/s12998-019-0238-y) contains supplementary material, which is available to authorized users.

Claim Costs, Musculoskeletal Health, and Work Exposure in Physical Therapists, Occupational Therapists, Physical Therapist Assistants, and Occupational Therapist Assistants: A Comparison Among Long-Term Care Jobs

BACKGROUND

Patient/resident-handling tasks are physically demanding and associated with musculoskeletal disorders (MSDs) among nursing personnel. The routine performance of such tasks by physical therapists and occupational therapists during treatment can cause similar problems.

OBJECTIVE

This study characterized the magnitude of MSDs and the risk factors for MSDs in physical therapists, occupational therapists, physical therapist assistants, and occupational therapist assistants (collectively called "therapy personnel" for this study) and compared them with those of other nursing home workers, especially nursing staff.

DESIGN

This was a cross-sectional study.

METHODS

Workers' compensation claim (WCC) data from 1 year of experience in a long-term care company were used to compute claim rates by body region, nature, and cause of injury, and the costs per case and per full-time-equivalent employee. Data regarding musculoskeletal symptoms, use of patient/resident-lifting equipment, and perceived physical and psychological job demands were obtained from a concurrent cross-sectional survey of workers from 24 long-term care facilities.

RESULTS

About 80% of the WCCs were related to musculoskeletal incidents in nursing aides and therapy personnel. WCC costs paid per case for therapy personnel were more than twice those for nursing staff for both ergonomic and resident-handling incidents. Prevalence of low back pain in therapy personnel was the same as in nursing aides (48%) but involved more chronic, milder pain. About half of therapy personnel reported "never" or "rarely" using patient/resident-lifting equipment. Therapy personnel, nursing aides, and housekeeping/dietary/maintenance personnel reported the highest physical job demands.

LIMITATIONS

Causal inference cannot be determined due to the cross-sectional nature of the survey data. Study findings are relevant only to therapy work in long-term care settings because exposures vary in other health care settings (hospitals, outpatient, and others).

CONCLUSIONS

MSD prevalence and claim costs in therapy personnel are high enough to deserve more attention. The low use of patient/resident-lifting equipment in therapy could increase the risk for MSDs. Future studies with comprehensive ergonomic analysis of therapist tasks and recommendations to reduce injuries are warranted.

Work-Related Upper Limb Symptoms in Hand-Intensive Health Care Occupations: A Cross-Sectional Study With a Health and Safety Perspective

BACKGROUND

Research with physical therapists reveals high rates of work-related musculoskeletal injuries, especially low back pain, with early career onset. Less focus has been given to upper limb disorders (ULDs) in these professionals, who frequently perform repetitive arm/hand and precision finger motions during work.

OBJECTIVE

The objective was to estimate prevalence of body-site-specific upper limb (UL) symptoms and diagnosed ULDs in Irish chartered physical therapists, physiotherapists, and athletic therapists, with adjustment for leisure time injury, and document first onset of specific UL symptoms.

DESIGN

The design was a cross-sectional survey (N = 347) using random sampling (physiotherapists in private practice), proportionate cluster sampling (hospital-based physiotherapists), and all-population sampling (physical therapists and athletic therapists).

METHODS

The methods used were a postal questionnaire with annual, current, and incapacitating UL symptoms (neck, shoulders, elbows, wrists, fingers, thumbs) (Nordic Questionnaire); symptom onset; diagnosed UL disorders; and sociodemographics; prevalence with 95% CIs, and adjusted prevalence (general linear modeling).

RESULTS

Adjusted annual prevalence of UL symptoms in at least 1 body site was 78.1% (95% CI = 71.4-82.2), and of incapacitating symptoms was 21.0% (95% CI = 16.4-27.0). Shoulder (53.2%, 95% CI = 47.9-58.7), neck (49.4%, 95% CI = 44.2-55.0), and thumbs (46.1%, 95% CI = 40.7-51.5) were mostly affected. Hospital-based therapists had a significantly higher prevalence of incapacitating symptoms compared with others (35.7% vs 23.3%). Respondents totaling 28.2% had at least 1 lifetime diagnosis of ULD, most commonly shoulder tendonitis (12.5%, 95% CI = 8.4-15.3) and overuse syndrome (11.8%, 95% CI = 8.4-15.3). First onset was mostly after 5 years working as a therapist; however, this differed by anatomical site.

LIMITATIONS

A cross-sectional study design limited interpretation of symptoms as work-related causes.

CONCLUSIONS

The high prevalence of ULD and symptoms warrants attention from occupational health and safety personnel. Training in injury prevention and risk assessment should be provided during education and as part of continuing education.

The burden of low back pain among undergraduate physiotherapy students at the University of Zimbabwe: a cross-sectional study

OBJECTIVE

Globally, non-specific low back pain (NSLBP) is a common cause of morbidity in all people including physiotherapy students. However, no study has investigated the problem among undergraduate physiotherapy students in Zimbabwe. This study was conducted, therefore, to provide evidence of the prevalence, clinical characteristics and consequences of recurrent NSLBP among undergraduate physiotherapy students at the University of Zimbabwe.

RESULTS

The final sample had 90 participants, giving a study response rate of 97.8%. The median age of the participants was 22 years. The lifetime prevalence of NSLBP was 56.7% (n = 51) and the mean age of onset for NSLBP was 19.7 years (SD = 1.64 years). The 12-month prevalence of recurrent NSLBP was 38.9% (n = 35). Of the 35, 20 (57.1%) experienced at least three episodes in the last 12 months. Each episode lasted for 1-7 days in most participants (n = 31, 88.6%). The mean intensity of recurrent episodes was 3.37 (SD = 1.43) measured on Visual Analogue Scale. Only 7 (20%) experienced at least one functional limitation due to recurrent NSLBP. Additionally, only 2 (5.7%) sought medical treatment for the pain. However, 6 (17.1%) had to be absent from the university secondary to recurrent NSLBP.

Work-related musculoskeletal injuries in prosthetists and orthotists in Australia

Objective. This study aims to determine the prevalence of work-related musculoskeletal disorders in prosthetists/orthotists working in Australia. Secondary to this, the relationship between work-related hazards and work-related musculoskeletal disorders will be examined. Methods. In 2012, a self-report survey was conducted with the prosthetist/orthotist workforce in Australia (N = 139, 56% response rate). Data on workplace physical and psychosocial hazards, job satisfaction, work-life balance and musculoskeletal discomfort were collected. Predictors of work-related musculoskeletal disorders were assessed using logistic regression analysis. Results. Prevalence of work-related musculoskeletal disorders was 80%. Gender (β = 1.31, p = 0.030), total weekly hours (β = 0.9, p < 0.010) and physical (β = 1.91, p < 0.010) and psychosocial (β = 1.28, p < 0.010) hazards were all associated with reporting of work-related musculoskeletal disorders. Females reported higher levels of work-related musculoskeletal disorder discomfort than males in all body areas. Conclusions. Work-related musculoskeletal disorders prevalence is high in prosthetists/orthotists. This suggests that focus on workplace injury prevention is required. Targeted prevention requires systematic identification and then control of all relevant workplace hazards.

Musculoskeletal Symptoms among Family Caregivers of Community-Dwelling Stroke Survivors in Nigeria

Introduction: Caring for stroke survivors may be burdensome with adverse consequences on caregivers' physical health. This study examined the prevalence of musculoskeletal symptoms and associated factors among family caregivers of stroke survivors in Nigeria. Methods: A hospital-based cross-sectional study involving 90 stroke caregiver and stroke survivor dyads was conducted. Data on the participants' demographics and post-stroke duration were obtained. Seven-day prevalence of musculoskeletal symptoms among the caregivers and level of stroke survivors' disability were respectively assessed using the Nordic Musculoskeletal Questionnaire and Modified Rankin Scale. Prevalence of musculoskeletal symptoms was presented as percentages while participants' characteristics associated with prevalence of musculoskeletal symptoms were examined using inferential statistics. Results: Mean (SD) age of caregivers and stroke survivors was 33.2 (10.7) years and 58.9 (9.7) years respectively. Majority of the caregivers were females (61.1%), and children of the stroke survivors (58.9%). Prevalence of musculoskeletal symptoms was 82.2%. The low back was the most affected body region (72.2%) followed by the upper back (40%) while musculoskeletal symptoms in the wrist was least prevalent (3.3%). Female caregivers, caregivers of female stroke survivors and spousal caregivers had significantly higher prevalence of musculoskeletal symptoms compared to other categories of caregivers. Only 5 (5.6%) caregivers had however received any training on safe care giving methods while only 21 (28.4%) caregivers with musculoskeletal symptoms had received treatment. Conclusion: With the high prevalence of musculoskeletal symptoms among family caregivers of stroke survivors, effective preventive strategies including training and education as well as timely access to treatment would be required.

Relationships between presenteeism and work-related musculoskeletal disorders among physical therapists in the Republic of Korea

This study investigated the relationship between presenteeism and work-related musculoskeletal disorders (WMSDs) among physical therapists (PTs) in the Republic of Korea. Questionnaires were given to 600 PTs in the Republic of Korea. General and occupational characteristics and the prevalence of presenteeism and absenteeism were self-reported on the questionnaire. Stepwise regression analyses were used to evaluate the effects of presenteeism and other variables on general and occupational characteristics. Of the 490 PTs who responded, 399 (81.4%) reported at least one WMSD. There was a low incidence rate of absenteeism, but work impairment scores indicate there was a high incidence of presenteeism. In the stepwise regression analyses, the incidence of WMSDs was highest in cases of presenteeism. The results of this study demonstrate that there is a high incidence rate of WMSDs in Republic of Korean PTs, that WMSDs are related to presenteeism and that PTs demonstrate high presenteeism and low absenteeism.

Musculoskeletal Disorders Among Greek Physiotherapists: Traditional and Emerging Risk Factors

Background

Musculoskeletal disorders (MSDs) in the health industry are quite common, however, there have only been a few studies regarding physiotherapists, while in Greece, there is an apparent lack of research and data. The aim of this study is to investigate MSDs experienced by physiotherapists in Greece, their causes and specific measures, and good practices followed. Additional emerging risk factors will be examined.

Methods

A questionnaire of MSDs followed by individual and workplace characteristics was completed by 252 physiotherapists. It covered the major workplace categories such as public hospitals, private rehabilitation centers, and private practices.

Results

Analysis indicated that 89% of the respondents had experienced a work-related MSD; 32.2% of those injuries occurred within the first 5 years of working. The most lumbered physiotherapists were those working as private practitioners and almost half of the injured respondents chose to work while injured. The most common measure taken to tackle work related MSDs was found to be physical therapy sessions. Job satisfaction and psychosocial issues were also identified as side-effects of the economic slowdown.

Conclusion

Physiotherapists in Greece were found to suffer from MSDs; workplace musculoskeletal injuries were quite common but under-reported. The body parts most affected were the lower back, the upper back, the shoulders, and the neck. There was a strong correlation between the workplace setting and the number of MSDs. A well-defined occupational safety and health management system and strict administration steering were found to reduce MSDs. The economic slowdown experienced in Greece during the execution of this study placed additional pressure on physiotherapists.

Work-Related Low Back Pain Among Physical Therapists in Riyadh, Saudi Arabia

Low back pain (LBP) is a common health problem. Professions like physical therapy (PT), involving frequent lifting, bending, or standing, are at risk for developing LBP. The objective of this study was to determine the prevalence of work-related LBP and factors associated with and consequences of work-related LBP among physical therapists in Riyadh, Saudi Arabia. A self-administered online questionnaire (i.e., demographic data, history of LBP before and after working as a physical therapist, work setting, and effect on daily activities) was sent to 600 members of the Saudi PT association. Data were analyzed using the Pearson chi-square test and Mann-Whitney U test. Eighty-eight percent of potential respondents completed the questionnaire. Of these, 89.65% of the therapists reported LBP after beginning their PT practice, and 35.6% reported LBP at the time of this survey. Gender, PT specialty, and duration of contact with patients were all found to be related to LBP. The prevalence of work-related LBP among physical therapist in Riyadh was high, affecting patient care and daily activities of the therapists. Both primary and secondary prevention strategies (e.g., introduce ergonomics into PT curricula, reduce therapist stress, and promote teamwork) are needed to decrease LBP among therapists, so they can effectively care for patients.

Work-related exposures and disorders among physical therapists: experiences and beliefs of professional representatives assessed using a qualitative approach

Background

According to international study results, physical therapists are afflicted with work-related musculoskeletal, psychosocial and dermal disorders as well as infections. The few existing studies in German-speaking regions focus mainly on dermal and psychosocial exposures and resulting complaints. An overview of all relevant work-related exposures and complaints of physical therapists is currently lacking.

We sought to identify work-related exposures based on the subjective experiences and beliefs of physiotherapeutic representatives, in order to identify relevant work-related complaints and diseases. Likewise we aimed to compare the international evidence with the actual situation of physical therapists in Germany.

Methods

Two complementary qualitative approaches were used: 1) a focus group discussion with representatives of professional physiotherapy associations as well as health and safety stakeholders and 2) qualitative semi-structured telephone interviews incorporating currently employed physical therapists. The group discussion was conducted applying a moderation technique, and interviews were analyzed using the content analysis approach by Mayring.

Results

The focus group discussion with five participants and the 40 semi-structured interviews with physical therapists identified comparable results. The main exposures of physiotherapeutic work were considered to be musculoskeletal (e.g., awkward body postures during treatment, patient transfers, passive mobilization), psychosocial (e.g., statutory audit of prescriptions and the associated conflicts with doctors and health insurance providers) and partly dermal and infectious (e.g., wet work and risk of infection) factors. Diseases of the spine, wrist or finger joints, burnout syndrome and infections were mentioned as possible consequences.

Conclusions

The subjective data generated by both groups (focus group discussion and interviews) were comparable and consistent with the current state of research. The results provide new insight regarding work-related exposures and diseases of physical therapists working in Germany. These findings aided the design of a German-wide representative survey of practicing physical therapists.

Prevalence causes and impact of work related musculoskeletal disorders among physical therapists

BACKGROUND

Physical therapists are particularly vulnerable to work-related musculoskeletal disorders (WRMDs).

OBJECTIVE

To evaluate the prevalence, causes and impact of WRMDs among physical therapists in the Kingdom of Saudi Arabia (KSA).

METHODS

A cross-sectional study of physical therapists using a valid and reliable questionnaire. A total of 690 completed surveys were returned (response rate = 69%). The T-test and Pearson's correlation were used to identify correlations between variables and the incidence of WRMDs.

RESULTS

Working hours/week and WRMDs were significantly correlated (p = 0.005). Lower back (46.5%) and neck (26.6%) pain were most commonly encountered. WRMDs were significantly correlated with altered work habits (p = 0.036) but not with body mass index (p = 0.297). The prevalence of WRMDs among physical therapists was 47.7% with a significant difference between full- and part-time practice (p = 0.023). Adjustable beds/plinths (20%) and splints (18%) were the most commonly used assistive devices.

CONCLUSIONS

Physical therapists are especially vulnerable to WRMDs with a prevalence of 47.7%. WRMDs are impacted by both work status and setting. Low back pain is the most common form of WRMDs (46.5%). Avoidance of poor work habits, increased ergonomic awareness and application of safety measures are essential to prevent WRMDs.

Kinematic Analyses of the Thumb during Simulated Posteroanterior Glide Mobilization

Objective

Thumb problems are common in some health professionals such as physical therapists. The purpose of this case-control study is to investigate the influence of clinical experience and different mobilization techniques on the kinematics of the thumb.

Methods

Twenty-three participants without exposure to manual techniques (the Novice Group) and fifteen physical therapists with at least 3 years of orthopedic experience (the Experienced Group) participated. The kinematics of the thumb while performing 3 different simulated posteroanterior (PA) glide mobilization techniques on a load cell was monitored. These 3 techniques were: 1) unsupported, 2) with digital support and 3) with thumb interphalangeal joint supported by the index finger. The amount of forces exerted were 25% to 100% of maximum effort at 25% increments. The main effects of experience and technique on thumb kinematics were assessed.

Results

Both experience and technique had main effects on the flexion/extension angles of the thumb joints. Experienced participants assumed a more flexed position at the carpometacarpal (CMC) joint, and the novice participants performed with angles closer to the neutral position (F = 7.593, p = 0.010). Participants’ metacarpophalangeal (MCP) joints were in a more flexed position while performing PA glide with thumb interphalangeal (IP) joint supported by the index as compared to the other two techniques (p < .001).

Conclusions

Negative correlations were generally obtained between the sagittal plane angles of adjacent thumb joints during mobilization/manipulation. Therapists are recommended to treat patient with more stable PA glide mobilization techniques, such as PA glide with thumb interphalangeal joint supported by the index finger, to prevent potential mobilization-related thumb disorders.

Strategies to overcome size and mechanical disadvantages in manual therapy

The practice of manual therapy (MT) is often difficult when providing care for large patients and for practitioners small in stature or with other physical limitations. Many MT techniques can be modified using simple principles to require less exertion, permitting consistency with standards of practice even in the presence of physical challenges. Commonly used MT techniques are herein described and demonstrated with alternative preparatory and movement methods, which can also be adopted for use in other techniques. These alternative techniques and the procedures used to adapt them warrant discussion among practitioners and educators in order to implement care, consistent with the best treatment evidence for many common musculoskeletal (MSK) conditions. The inclusion in educational curricula and MT training programs is recommended to enrich skill development in physical therapists (PTs), spanning entry-level practitioners to those pursuing advanced manual skills.

Work-related musculoskeletal disorders among physical therapists: A systematic review

Physical therapists (PTs) perform demanding tasks that can lead to work-related musculoskeletal disorders (WMSD), but the rates and characteristics of WMSD among PTs are not well known. The objective of this systematic review of the literature was to integrate the information published on the prevalence, types, and risks for WMSD among PTs. Four databases were searched using combinations and synonyms for WMSD, discomfort, symptoms, and PTs. Two reviewers independently searched and screened peer-reviewed articles published in English evaluating WMSD in PTs; agreement between reviewers was evaluated. From 867 unduplicated articles, 32 were eligible and included. Up to 90% of PTs have WMSD during their careers; 50% experience WMSD within 5 years of practice. Low back was the body part most commonly affected. Female PTs and PTs working in hospitals have higher prevalence of WMSD. WMSD are associated with PTs' age, gender, specialty and job tasks. Performing manual therapy, lifting and transferring patients are tasks commonly associated with PTs' developing WMSD. The body parts affected differed by specialty and tasks. The findings presented in this review are useful to inform future research, quality improvement, and educational programs to reduce the rates of WMSD among PTs.

Associations between work-related musculoskeletal disorders, quality of life, and workplace stress in physical therapists

This study was performed to determine the associations between work-related musculoskeletal disorders (WMSDs), quality of life (QoL), and workplace stress among physical therapists (PTs) in South Korea. Self-reporting questionnaires were given to 855 PTs. Variables examined included general characteristics, WMSDs, QoL, and workplace stress. Of the 788 PTs who responded, 745 (94.5%) reported WMSDs affecting at least one body site. The most affected WMSDs site was the shoulder (23.3%), and the most reported number of body sites affected by WMSDs was one (50.9%). QoL was significantly improved (p<0.05) among PTs over 39 years old, who had 10-15 years of professional experience, worked in general/university hospitals, and had only one site affected by WMSDs. Factors influencing QoL included number of body sites affected by WMSDs, presence/absence of WMSDs, working venues, workplace stress, and age. Factors affecting workplace stress included number of body sites affected by WMSDs, QoL, work hours, and gender. The results showed a high prevalence of WMSDs among PTs in South Korea, and this negatively affected both QoL and workplace stress.

The occurrence of overload at work and musculoskeletal pain in young physiotherapists

BACKGROUND

A job requiring stooping, lifting, carrying loads and multiple repetitions of the same movement patterns leads to overloading the musculoskeletal system.

OBJECTIVE

The aim of the study was to assess the work-related load experienced by physiotherapists and the occurrence of the musculoskeletal system overload.

METHODS

The study included 108 young physiotherapists, 69 women and 39 men, aged from 25 to 35 years (mean 27.12 ± 3.72 years). The study used an anonymous questionnaire and Quick Exposure Check.

RESULTS

The most common musculoskeletal complaints were as follows: 70 physiotherapists (64.8%) reported low back pain, 60 (55.6%) cervical pain, and 34 (31.5%) pain in the wrists and fingers. Statistically significant positive correlations were revealed between the number of years worked in the profession and shoulder pain. The number of hours of work per week was positively correlated with the occurrence of pain in all analyzed body areas. Professional experience was negatively correlated with the level of stress felt. Physiotherapists dealing with manual therapy and exercise physiotherapy were particularly vulnerable to musculoskeletal overload.

CONCLUSIONS

Popularization of knowledge regarding ergonomics among physiotherapists could reduce the occurrence of musculoskeletal overload.

Allied Health Professionals and Work-Related Musculoskeletal Disorders: A Systematic Review

Work-related musculoskeletal injuries and disorders (WMSD) are a significant issue in the health care sector. Allied Health professionals (AHP) in this sector are exposed to physical and psychosocial factors associated with increased risk of developing a WMSD. Clarification of relevant hazard and risk factors for AHP is needed to improve understanding and inform WMSD risk management. A systematic analysis of the literature was undertaken to determine prevalence and risk factors for WMSD in AHP. Databases of Ovid MEDLINE, CINAHL (EBSCO), EMBASE and the Cochrane Database of Systematic Reviews were reviewed. This quality of articles was low. Outcome measures were varied, with prevalence rates of WMSD reported from 28% to 96% over a one-year time period. The lower back was the most commonly affected body part. Relevant factors identified with the development of WMSD included inexperience in the role and area of employment. Future research needs to focus on undertaking high quality prospective studies to determine the factors associated with WMSD development in AHP.