Work-Related Musculoskeletal Disorders among Physical Therapists in the Kingdom of Saudi Arabia: Prevalence, Characteristics, and Impact

Musculoskeletal injuries caused or made worse by the workplace or its surroundings are referred to as work-related musculoskeletal disorders (WMSD). Smoking, having a higher body mass index (BMI), having a high physical load or psychosocial stress, and having comorbidities (pain, arthritis, and rheumatism) are risk factors for WMSD. [1-3] Heavy lifting, clumsy postures, and excessive repetition are major biomechanical risk factors for WMSD.[1] Physical therapists (PTs) continue to have a significant risk of WMSD despite having a great deal of expertise in ergometrics and injury prevention.[4-6] The incidence of WMSD in PTs has been the subject of many investigations. In Kuwait, PTs with WMSD had a 1-year frequency of 47.6%; the low back (32%), neck (21%), and upper back (13%), were the most often affected regions.[7, 8] The 1-year prevalence in Nigeria was 91.3%, with the neck (34.1%) and low back (69.8%) being the most affected regions. Two main risk factors for WMSD were being female and having a lower BMI. In Izmir, Turkey, PTs had a lifetime incidence of 85% for WMSD; the most susceptible areas were the neck(12%), shoulders(14%), low back(26%), and hand-wrist(8%). The most common movement that led to the development of WMSD was transferring patients (15%).[9] The lifetime frequency of WMSD in Israel was 83%, with the lower back accounting for 80% of cases.[10] In Greek, 89% of PTs had lifetime WMSD

prevalence.[11] The occurrence of WMSD in PTs has been the subject of fewer investigations. The 1-year incidence of WMSD among PTs varied from 16.9 to 20.7 injuries per 100 full-time workers, according to two studies conducted in the USA. [12,13] According to a different research, the 3-year incidence of WMSD was 21.4 injuries per 100 full-time workers for younger PTs and 19.6 injuries for older PTs.In [14]

These investigations did demonstrate the universality of WMSD in PTs, despite the disparity in technique and reported figures. Healthcare systems have a heavy direct cost burden from WMSD, which also causes a larger indirect productivity loss. PTs with WMSD saw significant changes in their career aspirations and a decrease in their clinical longevity, both at work and at home.[15] According to a research, WMSD forced every single one of every six physical therapists to modify their workload or even quit.(16–19) Many cross-sectional studies have reported on the prevalence of WMSD in PTs; however, longitudinal data on the prevalence's progression are rare. In this study, we used Taiwan's national claims database to analyze the incidence and prevalence of WMSD in PTs. Physical therapists from Saudi Arabia's governmental and private sectors participated in this cross-sectional study. Participants in the study were physical therapists who were registered members of the Saudi Physical Therapy Association (SPTA), had at least one year of work experience, and worked at least one hour a day in their present setting. Therapists who were elderly, retired, or not in practice at the time of the inquiry were excluded from the research.

The researchers made contact with the physical therapists who belonged to the SPTA and extended an invitation to participate voluntarily in the study. In addition to the online survey, every participant received a letter over email explaining the purpose of the study. The researchers gave each participant an explanation of the questionnaire and their phone number in case more information was required. Each participant declared their willingness to participate in the study by responding to the questionnaire. Each participant spent between fifteen and twenty minutes to complete the questionnaire. After the online questionnaire was posted, the researchers sent out a courteous reminder to every participant requesting them to finish it if they hadn't already, one month later. The study did not include questionnaires that were completed.

The main objective of the survey was to collect data from physical therapists on their self-reported musculoskeletal pain and concerns linked to their jobs. It was written in English, had six parts, and had previously passed validation. The first segment of the survey collected the participants' demographic information. The participant's background, experience, professional rank, working hours, primary patient type, working locations, areas of specialization, longest spell (in days), total number of episodes, type of complaints, how they began, type of treatment received, whether they had seen an expert regarding the complaint, work position, and exercise regimen were all questioned about in the following section. The Nordic Musculoskeletal Questionnaire was used to evaluate the participant's musculoskeletal complaints (pain or discomfort) in nine anatomical regions: the neck, shoulders, elbows, hands/wrists, and thumbs. A body diagram was used for this purpose. In the next component, the length of WMSDs was evaluated using the question, "How long does the pain or discomfort typically last?" The following options were presented to the participants for selection: 1) A day, 2) A week, 3) A month, 4) A week and a half, or 5) A month and a half will pass. To determine the frequency of WMSDs, the following question was following options: The conceivable frequency of usage is once every six months or less, once every two to three months, once a month, once a week, or more than once a week. The level of discomfort was measured using a Visual Analogue Scale (VAS), which ranged from 0 (no pain) to 10 (the worst agony imaginable) for each body area. These were the employment characteristics on the questionnaire that physical therapists found to be associated with WMSDs. The last component covered the methods used by physical therapists to manage WMSDs.

For the statistical analysis, the SPSS software (SPSS version 21.0 for Windows; Inc., USA) was used. Descriptive statistics were used to estimate sample demographics and the incidence of WMSDs. Using incidence rates and cross-tabulations, a variety of demographic traits and work settings were associated with the existence of WMSDs. The chi-square test was used to evaluate the relationship between the incidence and correlation of WMSDs and the professional characteristics of physical therapists, work settings, and demographic variables. The significance criterion was established at a p-value of < 0.05 for all studies.

Out of the 137 licensed physical therapists who were asked to participate in the research, 115 of them completed the questionnaires. Fifteen of these surveys were incomplete, and as a result, they were not included in the study. As a result, the prevalence rates were ultimately assessed using the data from 100 individuals.

Table 1 displays the attributes for every topic. There were 42 (42%) female participants and 58 (58%) male participants. The bulk of physical therapists—56 percent—were employed by government hospitals. The most common specialization was orthopedics, which was followed by neurology, pediatrics, and other disciplines. Physical therapists worked more than 40 hours per week on average (42%; Table 1). Table 1: Description of the Participants

Gender significantly influenced the frequency of work-related neck and low back symptoms, with more women than men reporting these issues. Similarly, complaints of the shoulders and low back linked to employment were associated with participant age and were more common in younger age groups. Neck issues relating to the workplace were linked to certain industries and job roles. There was statistical significance in all of these associations (p < 0.001). (table 2).

Table 3 shows that the majority of Saudi Arabian physical therapists experienced two to five episodes of wrist/hand, elbow/forearm, neck, shoulder, and thumb WMSDs. The most common complaint was pain, which was followed by stiffness, spasms, and other symptoms. The majority of patients with problems related to their neck, shoulders, or elbows got physical therapy treatment, as shown by Table 3.

physicaltherapists

Fiure 2: Work-related musculoskeletal disorders (WMSDs) Characteristics among physical therapists

Physical therapists who responded to the poll said that working with many patients on a daily basis (48%) and staying in one place for lengthy periods of time (43%) were the two most important job impacts. The two least important characteristics were dealing with psychologically or disoriented patients (2%) and irregular work patterns (4%) (Table 4). Table 4: Risk factor that impact physical therapists

The study's result emphasizes how important it is for physical therapists in the Kingdom of Saudi Arabia to address the serious problem of musculoskeletal illnesses connected to their jobs. The frequency of these conditions emphasizes how crucial it is to put ergonomic treatments and preventative measures into practice in clinical settings. It is important to tackle risk factors, such as extended patient care and substandard ergonomic practices, in order to enhance the well-being of physical therapists and guarantee the longevity of their employment. Furthermore, the effect that WRMSDs have on physical therapists' everyday life and professional performance highlights the need of all-encompassing wellness programs and support networks in healthcare facilities. Workplaces should include strategies like ergonomic training, frequent breaks, and the availability of suitable equipment to reduce the incidence of musculoskeletal illnesses. In order to lower the incidence of WRMSDs and enhance the general working conditions for physical therapists in the Kingdom of Saudi Arabia, policymakers, healthcare organizations, and physical therapy practitioners may benefit from the insightful information provided by this research. Maintaining a viable and efficient healthcare system in the area requires giving these professionals' health and wellbeing first priority. among Lebanese dentists-trend evolution. J Oral Med Toxicol 1(1):1–5 2. Ahmed AS, Oraby EE (2017) Work-related musculoskeletal disorders among dentists in Sharkia Governmental Hospitals, Egypt. Egypt J Occup Med 41(2):175–186 3. Al Shammari M, Hassan A, Al Dandan O, Al Gadeeb M, Bubshait D (2019) Musculoskeletal symptoms among radiologists in Saudi Arabia: a multi-center cross-sectional study. BMC Musculoskelet Disord 20(1):541 4. Aseri KS, Mulla AA, Alwaraq RM, Bahannan RJ (2019) Characterizing occupational low back pain among surgeons working in ministry of health hospitals in Jeddah city: prevalence, clinical features, risk, and protective factors. KAU Med Sci 26(2):19–34 5. Atia DT, Abdelazeim FH, Radwan H (2015) Impact of work-related musculoskeletal disorders on Egyptian pediatric physical therapists: one-year follow-up study. Trends Appl Sci Res 10(3):175–182 6. Attar SM (2014) Frequency and risk factors of musculoskeletal pain in nurses at a tertiary Centre in Jeddah, Saudi Arabia: a cross sectional study. BMC Res Notes 7(1):61 7. Briggs AM, Woolf AD, Dreinhöfer K, Homb N, Hoy DG, Kopansky-Giles D, Åkesson K, March L (2018) Reducing the global burden of musculoskeletal conditions. Bull World Health Organ 96(5):366–368 GBD (2017/2018) Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392(10159): 1736–1788 8. Giurgiu DI, Jeoffrion C, Grasset B, Dessomme BK, Moret L, Roquelaure Y, Caubet A, Verger C, Laraqui CE, Lombrail P, Geraut C, Tripodi D (2015) Psychosocial and occupational risk perception among health care workers: a Moroccan multicenter study. BMC Res Notes 8(1):408 9. Gopal K, Thomas M, Sreedharan J (2012) Work-related musculoskeletal disorders (WMSD) in hospital nurses: prevalence and coping strategies. Gulf Med J 1(S1):S159–S163 survey of back pain beliefs in Canada. Spine 31(18):2142–2145 11. Habib RR, Frangieh M, Haddad N, Hojeij S, Coggon D (2011) Musculoskeletal pain and psychosocial factors among Lebanese workers. Occup Environ Med 68(Suppl 1):A67 12. Homaid MB, Abdelmoety D, Alshareef W, Alghamdi A, Alhozali F, Alfahmi N, Hafiz W, Alzahrani A, Elmorsy S (2016) Prevalence and risk factors of low back pain among operation room staff at a Tertiary Care Center, Makkah, Saudi Arabia: a cross-sectional study. Ann Occup Environ Med 28(1):1 13. Jaoude SB, Naaman N, Nehme E, Gebeily J, Daou M (2017) Work-related musculoskeletal pain among Lebanese dentists: an epidemiological study. Niger J Clin Pract 20(8):1002–1009 14. Khairy WA, Bekhet AH, Sayed B, Elmetwally SE, Esayed AM, Jahan AM (2019) Prevalence, profile, and response to work-related musculoskeletal disorders among Egyptian physiotherapists. Open Access Macedonian J Med Sci 7(10):1692–169. 15. Kumar S, Sadek MY, Sreedharan J (2012) Prevalence of upper quadrant musculoskeletal disorders among dental students and professionals in Ajman, UAE: an observational study. Gulf Med J 1(S1):S164–S168 16. Lin TH, Liu YC, Hsieh TY, Hsiao FY, Lai YC, Chang CS (2012) Prevalence of and risk factors for musculoskeletal complaints among Taiwanese dentists. J Dent Sci 7(1):65–71 Qareeballa AA, Alhamdan OA, Almutawaa AA, Alsayed IM, Kamal FA, Al Abdrabbuh DS, Al Suwaidi MK, Rashwan MA, Buhiji AM, Makarem BA (2018) Prevalence of low back pain among female nurses working in secondary and tertiary healthcare, Kingdom of Bahrain. Int J Med Sci Public Health 7(3):183–188 17. Soylar P, Ozer A (2018) Evaluation of the prevalence of musculoskeletal disorders in nurses: a systematic review. Med Sci 7(3):479–485 18. Tavakkol R, Kavi E, Hassanipour S, Rabiei H, Malakoutikhah M (2020) The global prevalence of musculoskeletal disorders among operating room personnel: a 19. Tyrovolas S, El Bcheraoui C, Alghnam SA, Alhabib KF, Almadi MA, Al-Raddadi RM, Bedi N, El Tantawi M, Krish VS, Memish ZA, Mohammad Y (2020) The burden of disease in Saudi Arabia 1990–2017: results from the global burden of disease study 2017. Lancet Planet Health (5):e195–e208

Physical Therapist, Armed Forces Center For Health Rehabilitation, Taif City -Saudi Arabia