Work-related thumb disorders in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques.

Heather Jenkins,Hellen Myezwa

doi:10.4102/sajp.v71i1.249

Heather Jenkins, Hellen Myezwa

Open Access

https://doi.org/10.4102/sajp.v71i1.249

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Abstract

Research questionWhat is the prevalence of and factors associated with work-related thumb problems (WRTP) in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques?DesignA cross-sectional, descriptive study design was used and data were collected using two Internet-based questionnaires.ParticipantsThe sample size calculated for the study was 284 using 95% confidence levels and a 5% margin of error. There were 395 participants that were included in the study.Outcome measuresThe variables measured included demographic, employment, educational and occupational factors.ResultsThe lifetime prevalence of WRTP in the physiotherapists was 65.3%. The manual techniques that were significantly associated with WRTP in the respondents who reported thumb problems were all grades of transverse glides applied to the spine as well as grade II–IV unilateral and central posterior-anterior pressures to the spine. The factors that remained significantly associated with WRTP in all 395 respondents after regression analysis were the cervical treatment of up to six patients a day and hyperextension > 30° of the non-dominant interphalangeal (IP) joint of the thumb.ConclusionThis study confirms that a high percentage of physiotherapists using manual therapy techniques to treat musculoskeletal conditions are experiencing WRTP.RecommendationsThe development of a valid and reliable WRTP screening tool is needed to aid in the identification of physiotherapists at risk and thus in the primary prevention of WRTP. A longitudinal study which follows newly qualified physiotherapists is recommended to investigate a possible cause-effect relationship and preventative strategies for WRTP in physiotherapists.

Highlights

The World Health Organization (Luttman, Griefahn & Caffier 2003) defines a work-related musculoskeletal disorder (WRMSD) as a form of ill health ranging from light transitory disorders to irreversible disabling injuries that are induced or aggravated by work and related circumstances
The lifetime prevalence of work-related thumb problems (WRTP) ranged from 62.5% to 83% in studies focusing on wrist and thumb disorders (Barnes et al 2011; McMahon et al 2006; Wajon & Ada 2003)
Inclusion criteria South African physiotherapists registered with the South African Society of Physiotherapists (SASP) who were treating or have previously treated musculoskeletal conditions using manual therapy techniques were included in the study

Summary

Introduction

The World Health Organization (Luttman, Griefahn & Caffier 2003) defines a work-related musculoskeletal disorder (WRMSD) as a form of ill health ranging from light transitory disorders to irreversible disabling injuries that are induced or aggravated by work and related circumstances. Several international studies (Bork et al 1996; Holder et al 1999) reported a 32% lifetime prevalence of WRMSD in physiotherapists, whilst Cromie, Robertson and Best (2000) and West and Gardner (2001) reported a higher lifetime prevalence of WRMSD of 91% and 55% respectively. A hands-on approach of manual therapy is predominantly used in orthopaedic outpatient departments or private practices treating musculoskeletal disorders. Increased use of their hands puts these physiotherapists at risk of developing WRMSD of the wrists and hands (Barnes et al 2011; Cromie et al 2000; McMahon, Stiller & Trott 2006; Snodgrass & Rivett 2002; West & Gardner 2001). The lifetime prevalence of work-related thumb problems (WRTP) ranged from 62.5% to 83% in studies focusing on wrist and thumb disorders (Barnes et al 2011; McMahon et al 2006; Wajon & Ada 2003)

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