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The Chartered Society of Physiotherapy

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The Chartered Society of Physiotherapy

  1. 1. <ul><li>WORK-RELATED MUSCULOSKELETAL DISORDERS </li></ul><ul><li>Warren Glover </li></ul><ul><li>Research & Policy Officer </li></ul><ul><li>CSP Employment Relations & Union Services </li></ul><ul><li>[email_address] </li></ul>
  2. 2. ‘ THE MSD PROJECT’ <ul><li>Annual Representative Conference (ARC) motion 1999 </li></ul><ul><li>MSDs widely considered a problem in health </li></ul><ul><li>Wealth of info on nurses but ‘physiotherapists often neglected in research’ </li></ul><ul><li>Cromie et al (2000) 91% lifetime prevalence in Australian physical therapists </li></ul><ul><li>Ramifications for CSP members (health & safety) & Government policy (retention) </li></ul>
  3. 3. METHOD <ul><li>Self administered questionnaire </li></ul><ul><li>Randomly selected 10% sample of CSP members </li></ul><ul><li>3,661 questionnaires distributed (summer 2003) </li></ul><ul><li>2,688 returned </li></ul><ul><li>73.4% response </li></ul>
  4. 4. DEMOGRAPHICS <ul><li>89.4% female, 10.6% male </li></ul><ul><li>average age: 39.5 (range 20-80) </li></ul><ul><li>53.2% full-time, 36.6% part-time </li></ul><ul><li>73% working in NHS (60.7% in hospitals) </li></ul><ul><li>33.7% in Gen Musculoskeletal Outpatients </li></ul><ul><li>42.5% Senior I/Super IV grade </li></ul>
  5. 5. RESULTS <ul><li>Career prevalence: 67.5% </li></ul><ul><li>Annual prevalence: 58.0% </li></ul><ul><li>Symptoms >3 days: 41.5% </li></ul><ul><li>Within last week: 25.5% </li></ul><ul><li>Multiple injury: 43.2% </li></ul><ul><li>Over 4 MSDs: 10.0% </li></ul>
  6. 6. PREVALENCE <ul><li>Body Area Career Annual Worst </li></ul><ul><li>Low back 48.4% 37.2% 44.2% </li></ul><ul><li>Neck 33.0% 25.7% 13.6% </li></ul><ul><li>Upper back 23.4% 18.4% 12.0% </li></ul><ul><li>Thumbs 23.3% 17.8% 10.2% </li></ul><ul><li>Shoulders 19.5% 14.8% 6.4% </li></ul><ul><li>Wrists/hands 16.7% 12.5% 6.8% </li></ul><ul><li>Whole Body 67.5% 58.0% n/a </li></ul>
  7. 7. Most Significant Injury <ul><li>Spinal 69.8%, Upper limb 24.8% </li></ul><ul><li>58.5% under age 30 at initial onset </li></ul><ul><li>32% within 5 years of graduating </li></ul><ul><li>Little variation in average number of hours spent in direct patient contact </li></ul><ul><li>Except thumb injury - 49% over 32 hours per week performing manipulations </li></ul>
  8. 8. CLINICAL SPECIALTY <ul><li>General Musculoskeletal </li></ul><ul><li>Outpatients: 31.2% </li></ul><ul><li>Neurological rehabilitation </li></ul><ul><li>(neuro rehab): 13.6% </li></ul><ul><li>Elderly care: 12.1% </li></ul><ul><li>All others: <10% </li></ul>
  9. 9. GENERAL MUSCULOSKELETAL OUTPATIENTS <ul><li>Thumbs 75.5% </li></ul><ul><li>Wrists/hands 49.2% </li></ul><ul><li>Upper back 42.6% </li></ul><ul><li>Neck 36.1% </li></ul><ul><li>Shoulders 27.4% </li></ul><ul><li>Low back 16.6% </li></ul>
  10. 10. NEURO (REHAB) <ul><li>Low back 17.9% </li></ul><ul><li>Elbow/forearm 17.4% </li></ul><ul><li>Shoulders 16.8% </li></ul><ul><li>Knees 16.1% </li></ul><ul><li>Neck 11.8% </li></ul><ul><li>Wrists/hands 11.7% </li></ul>
  11. 11. ELDERLY CARE <ul><li>Hips/thighs 25.0% </li></ul><ul><li>Knees 22.6% </li></ul><ul><li>Ankles/feet 20.0% </li></ul><ul><li>Low back 14.4% </li></ul><ul><li>Upper back 13.4% </li></ul>
  12. 12. Job Risk Factors <ul><li>Performing the same task over and over </li></ul><ul><li>Working in the same position for long periods </li></ul><ul><li>Treating a large number of patients in one day </li></ul><ul><li>Bending or twisting back in an awkward way </li></ul><ul><li>Lifting or transferring dependent patients </li></ul><ul><li>Continuing to work when injured or hurt </li></ul><ul><li>Inadequate training in injury prevention </li></ul>
  13. 13. Consequences of injury <ul><li>Sought physio treatment informally from a colleague (61%) </li></ul><ul><li>Modified physio techniques (59%) </li></ul><ul><li>Consulted a doctor/GP (39%) </li></ul><ul><li>Took sick leave (32%) </li></ul><ul><li>Reported injury to manager (16%) </li></ul><ul><li>Occupational health (12%) </li></ul><ul><li>Filled in accident form (10%) </li></ul><ul><li>Decreased patient contact hours (9.4%) </li></ul>
  14. 14. Preventive strategies <ul><li>Adjust plinth/bed height: 85.8% </li></ul><ul><li>Modify my/patient’s position: 79.1% </li></ul><ul><li>Help handling heavy patient: 65.5% </li></ul><ul><li>The vast majority of preventive strategies adopted were deemed to be at least moderately effective </li></ul>
  15. 15. Summary <ul><li>High incidence of MSDs in CSP members: career prevalence 67.5% </li></ul><ul><li>48.4% low back problems </li></ul><ul><li>Younger physiotherapists & newly qualified graduates most at risk </li></ul><ul><li>1-in-16 move within or leave the profession because of MSDs </li></ul><ul><li>43.9% no risk assessment in current post </li></ul>
  16. 16. Conclusions <ul><li>Information rich, practice poor? </li></ul><ul><li>Inducted into illness? </li></ul><ul><li>Musculoskeletal damage - the legacy of physiotherapy? </li></ul>

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