A study to determine the type, prevalence, risk factors and coping strategies of physiotherapists experiencing work related neuro-musculoskeletal disorders in KwaZulu-Natal.

Abstract

Work related neuro-musculoskeletal disorders (WRNMD) account for the greatest burden of all types of injuries, and is a key area of concern in the health care sector. Physiotherapy often requires various labour intensive tasks and techniques, which may be done repetitively for prolonged periods. There is little data available on occupational injuries of Physiotherapists in KwaZulu-Natal Province, South Africa. The impact, effect and consequences of the dynamics and nature of physiotherapy needs to be assessed with particular focus on the neuro-musculoskeletal system of the physiotherapist, when executing the various techniques of physiotherapy practice. The aim of the study was to determine the prevalence of work related neuro-musculoskeletal disorders experience by physiotherapists, to identify the anatomical sites most affected, and to describe risk factors that contribute to injury and the coping strategies they use to overcome them. Study design: This study was a cross sectional point prevalence descriptive study using self administered questionnaires, with open- and closed-ended questions. A convenience sample was used of all physiotherapists practicing in the public and private sectors in KwaZulu-Natal were included, this constituting a sample of 681 professionals. Results: Of the 205 physiotherapist who participated, 86% reported having had incurred work related WRNMD. They reported that 38.5% of injury occurred in the first five years following graduation. The neck (33.2%) and the lower back (31.2%) were the anatomical areas most affected. The techniques associated with massage, mobilisation, manipulation, chest physiotherapy and general rehabilitation were found to have a significant relationship with prevalence of WRNMD (p value < .05). Physiotherapists practicing in the public sector hospitals showed a greater prevalence to injury compared to those in the private sector. Transferring dependent patients was described as a major risk by 62.5% of physiotherapist. Modifying the physiotherapist’s posture or patient’s treatment position was seen as the common effective strategy. Conclusion: The prevalence of WRNMD amongst physiotherapists is relatively high, with the neck and lower back being predominant sites of injury, the main risk factors being lifting or transferring of dependent patients, with the number of years of experience being a contributing factor. Those practicing in the clinical fields of chest, neurology and orthopaedics are more likely to incur WRNMD. The results of this study indicate that particular attention should be given to techniques of manual handling and to hand- intensive manual therapy techniques. Current coping strategies most used were modifying the patient’s position or the physiotherapist’s posture during treatment. Specific strategies should be developed by physiotherapists, with regards to how many hours it is safe to perform certain physiotherapy techniques e.g. percussion, or the number of patients that require labour intensive treatment such, as massage or manipulation, could be treated in a time period. This study highlights the fact that physiotherapists are presenting with work related neuro-musculoskeletal disorders which may pose a significant threat to the length of the physiotherapist’s career, their general well being, and the maintenance of a viable work force for healthcare organisations.