WORKRELATED MUSCULOSKELETAL DISORDERS

1

• WORK-RELATED MUSCULOSKELETAL DISORDERS
• Warren Glover
• Research Policy Officer
• CSP Employment Relations Union Services
• gloverw_at_csp.org.uk

2
THE MSD PROJECT

• Annual Representative Conference (ARC) motion
  1999
• MSDs widely considered a problem in health
• Wealth of info on nurses but physiotherapists
  often neglected in research
• Cromie et al (2000) 91 lifetime prevalence in
  Australian physical therapists
• Ramifications for CSP members (health safety)
  Government policy (retention)

3
METHOD

• Self administered questionnaire
• Randomly selected 10 sample of CSP members
• 3,661 questionnaires distributed (summer 2003)
• 2,688 returned
• 73.4 response

4
DEMOGRAPHICS

• 89.4 female, 10.6 male
• average age 39.5 (range 20-80)
• 53.2 full-time, 36.6 part-time
• 73 working in NHS (60.7 in hospitals)
• 33.7 in Gen Musculoskeletal Outpatients
• 42.5 Senior I/Super IV grade

5
RESULTS

• Career prevalence 67.5
• Annual prevalence 58.0
• Symptoms gt3 days 41.5
• Within last week 25.5
• Multiple injury 43.2
• Over 4 MSDs 10.0

6
PREVALENCE

• Body Area Career Annual Worst
• Low back 48.4 37.2 44.2
• Neck 33.0 25.7 13.6
• Upper back 23.4 18.4 12.0
• Thumbs 23.3 17.8 10.2
• Shoulders 19.5 14.8 6.4
• Wrists/hands 16.7 12.5 6.8
• Whole Body 67.5 58.0 n/a

7
Most Significant Injury

• Spinal 69.8, Upper limb 24.8
• 58.5 under age 30 at initial onset
• 32 within 5 years of graduating
• Little variation in average number of hours spent
  in direct patient contact
• Except thumb injury - 49 over 32 hours per week
  performing manipulations

8
CLINICAL SPECIALTY

• General Musculoskeletal
• Outpatients 31.2
• Neurological rehabilitation
• (neuro rehab) 13.6
• Elderly care 12.1
• All others lt10

9
GENERAL MUSCULOSKELETAL OUTPATIENTS

• Thumbs 75.5
• Wrists/hands 49.2
• Upper back 42.6
• Neck 36.1
• Shoulders 27.4
• Low back 16.6

10
NEURO (REHAB)

• Low back 17.9
• Elbow/forearm 17.4
• Shoulders 16.8
• Knees 16.1
• Neck 11.8
• Wrists/hands 11.7

11
ELDERLY CARE

• Hips/thighs 25.0
• Knees 22.6
• Ankles/feet 20.0
• Low back 14.4
• Upper back 13.4

12
Job Risk Factors

• Performing the same task over and over
• Working in the same position for long periods
• Treating a large number of patients in one day
• Bending or twisting back in an awkward way
• Lifting or transferring dependent patients
• Continuing to work when injured or hurt
• Inadequate training in injury prevention

13
Consequences of injury

• Sought physio treatment informally from a
  colleague (61)
• Modified physio techniques (59)
• Consulted a doctor/GP (39)
• Took sick leave (32)

• Reported injury to manager (16)
• Occupational health (12)
• Filled in accident form (10)
• Decreased patient contact hours (9.4)

14
Preventive strategies

• Adjust plinth/bed height 85.8
• Modify my/patients position 79.1
• Help handling heavy patient 65.5
• The vast majority of preventive strategies
  adopted were deemed to be at least moderately
  effective

15
Summary

• High incidence of MSDs in CSP members career
  prevalence 67.5
• 48.4 low back problems
• Younger physiotherapists newly qualified
  graduates most at risk
• 1-in-16 move within or leave the profession
  because of MSDs
• 43.9 no risk assessment in current post

16
Conclusions

• Information rich, practice poor?
• Inducted into illness?
• Musculoskeletal damage - the legacy of
  physiotherapy?