Department of Work Environment, University of Massachusetts Lowell, Lowell, MA 01854 (USA).
Department of Biomedical Engineering, Department of Work Environment, University of Massachusetts Lowell.
Phys Ther. 2019 Feb 1;99(2):183-193. doi: 10.1093/ptj/pzy137.
Patient/resident-handling tasks are physically demanding and associated with musculoskeletal disorders (MSDs) among nursing personnel. The routine performance of such tasks by physical therapists and occupational therapists during treatment can cause similar problems.
This study characterized the magnitude of MSDs and the risk factors for MSDs in physical therapists, occupational therapists, physical therapist assistants, and occupational therapist assistants (collectively called "therapy personnel" for this study) and compared them with those of other nursing home workers, especially nursing staff.
This was a cross-sectional study.
Workers' compensation claim (WCC) data from 1 year of experience in a long-term care company were used to compute claim rates by body region, nature, and cause of injury, and the costs per case and per full-time-equivalent employee. Data regarding musculoskeletal symptoms, use of patient/resident-lifting equipment, and perceived physical and psychological job demands were obtained from a concurrent cross-sectional survey of workers from 24 long-term care facilities.
About 80% of the WCCs were related to musculoskeletal incidents in nursing aides and therapy personnel. WCC costs paid per case for therapy personnel were more than twice those for nursing staff for both ergonomic and resident-handling incidents. Prevalence of low back pain in therapy personnel was the same as in nursing aides (48%) but involved more chronic, milder pain. About half of therapy personnel reported "never" or "rarely" using patient/resident-lifting equipment. Therapy personnel, nursing aides, and housekeeping/dietary/maintenance personnel reported the highest physical job demands.
Causal inference cannot be determined due to the cross-sectional nature of the survey data. Study findings are relevant only to therapy work in long-term care settings because exposures vary in other health care settings (hospitals, outpatient, and others).
MSD prevalence and claim costs in therapy personnel are high enough to deserve more attention. The low use of patient/resident-lifting equipment in therapy could increase the risk for MSDs. Future studies with comprehensive ergonomic analysis of therapist tasks and recommendations to reduce injuries are warranted.
患者/居民处理任务对护理人员的身体要求很高，并与肌肉骨骼疾病（MSD）有关。在治疗过程中，物理治疗师和职业治疗师常规执行此类任务也会导致类似的问题。
本研究旨在描述物理治疗师、职业治疗师、物理治疗助理和职业治疗助理（在本研究中统称为“治疗人员”）中 MSD 的严重程度和 MSD 风险因素，并将其与其他养老院工作人员（尤其是护理人员）进行比较。
这是一项横断面研究。
使用来自长期护理公司 1 年工作经验的工人补偿索赔（WCC）数据，按身体部位、损伤性质和原因计算索赔率，以及每例和每全职等效员工的费用。同时，从 24 个长期护理设施中进行的同期横断面调查中获得了有关肌肉骨骼症状、使用患者/居民搬运设备以及感知到的身体和心理工作要求的数据。
约 80%的 WCC 与护理助手和治疗人员的肌肉骨骼事件有关。对于治疗人员，与人体工程学和居民处理事件相关的 WCC 每例费用是护理人员的两倍多。治疗人员的腰痛患病率与护理助手相同（48%），但涉及更多慢性、较轻的疼痛。约有一半的治疗人员报告“从不”或“很少”使用患者/居民搬运设备。治疗人员、护理助手和家政/饮食/维护人员报告的体力工作要求最高。
由于调查数据的横断面性质，无法确定因果关系。研究结果仅与长期护理环境中的治疗工作相关，因为在其他医疗保健环境（医院、门诊和其他环境）中暴露情况有所不同。
治疗人员中的 MSD 患病率和索赔费用高得足以引起更多关注。治疗师任务中患者/居民搬运设备的低使用率可能会增加 MSD 的风险。需要进一步研究，对治疗师任务进行全面的人体工程学分析，并提出减少伤害的建议。
