Prevalence of Thumb Pain in Physical Therapists Practicing Spinal Manipulative Therapy (original) (raw)
Related papers
Manual Therapy, 2007
Pain is common in the thumbs of physiotherapists. The purpose of this observational study was to investigate whether there is an association between the alignment of the thumb during performance of postero-anterior (PA) pressures and the presence of thumb pain. One hundred and twenty-nine physiotherapists who attended the Musculoskeletal Physiotherapy Association Conference (2003) participated. After providing a history of any work-related thumb pain, participants applied a PA pressure mimicking the technique they would use on a cervical spine, while the position of their metacarpophalangeal (MP) and interphalangeal (IP) joints was photographed. There was an association (po0.05) between work-related thumb pain and alignment of the thumb during performance of PA pressures: participants who were able to maintain their MP and IP joints in extension were less likely to report pain. These findings serve as a guide to the safe performance of mobilization techniques, both for beginning practitioners and for experienced therapists complaining of thumb pain. r
Prevalence of Work-Related Thumb Pain in Physiotherapists
https://www.ijhsr.org/IJHSR\_Vol.11\_Issue.6\_June2021/IJHSR-Abstract.04.html, 2021
Background: Physiotherapy is associated with job tasks that are physically challenging and some of the routine procedures include manual therapy and soft tissue mobilizations which require higher levels of force and may be performed in hazardous or awkward postures. This study was done to find out the prevalence of work-related thumb pain amongst Physiotherapists and also to assess the awareness about the thumb pain and ergonomic strategies to reduce the same. Objectives: 1. To find the prevalence of Work-Related Thumb Pain (WRTP) in Physiotherapists 2. To assess the awareness of ergonomics related to WRTP in Physiotherapists 3. To find the coping strategies used by the Physiotherapists for WRTP Methods: 94 Physiotherapists from various setups in Pune city, with a basic qualification in B.P.Th. having a work experience of minimum 2 years and having minimum 20 hours of clinical duties per week and performing manual therapy techniques on patients were included in the study. Results: The overall prevalence came to 68.1%. 94.7% of the respondents were aware about the ergonomic strategies to prevent/reduce thumb pain and 5.3% were not aware about the same. Multiple coping strategies were used by the Physiotherapists, of which changing or modifying their treatment, modifying either the patient's position or their position, asking to help handle a heavy patient were the most common ones. Conclusion: This study indicates that thumb problems are common in Physiotherapists.
Work related thumb pain, its prevalence, risk factors and prevention among physical therapists
Background: Previous studies conducted worldwide which indicated that many physical therapists are prone to develop a thumb pain just because of their occupation. The nature of the work in a physical therapy practice is physically demanding which prone the physiotherapists to work related thumb pain (WRTP) as it involves repetitive tasks, high force manual techniques for treating patients. The objective of this study was to investigate the prevalence, risk factors and consequences of thumb pain arising due to physiotherapy. Methodology: An observational cross-sectional study was conducted from December 2017 to December 2018 and participating population included both male and female physiotherapists who are currently in practice. Participants that have undergone forearm or hand surgery, the victim of rheumatoid arthritis (RA) and those who were retired or working out of Karachi were excluded. The sample size was calculated through open epi version 3.0 and data was collected from 100 subjects from districts of Karachi (Saddar, Liaquatabad, North Karachi, Gulberg, North Nazimabad, Malir, Gulshan, Korangi and Orangi). The data was analyzed using SPSS Version 22. Pearson's Chi-square test was used to find out the association between WRTP among physical therapists. Results: According to the study results physical therapists are at increased risk of developing WRTP, with a prevalence of 48%. Physiotherapists that are most commonly affected by WRTP are 39% and they aged <30 years. It was found more prevalent among manual therapists (29%). Trigger point therapy is mentioned by 23% of the respondents as an important pain exacerbating cause for their WRTP. Also, manipulation (17%) and mobilization (17%) are the techniques that result in thumb pain. Change in the choice of treatment techniques (17%) is a consequence of WRTP. Conclusion: Physical therapists who are using manual therapy techniques in musculoskeletal conditions experienced more WRTP. However, thumb pain is mostly provoked by trigger point therapy. The best therapy for WRTP is rest, considering the most satisfaction about this treatment.
Thumb Pain in Physiotherapists Practicing Manual Therapy: Prevalence and Consequences
https://www.ijhsr.org/IJHSR\_Vol.10\_Issue.6\_June2020/IJHSR\_Abstract.030.html, 2020
Background: Injury pertaining to work around thumb area has become a well-recognized issue for physiotherapists who perform diverse manual techniques in the treatment of patients with musculoskeletal disorders. This may result in alteration in implementation of treatment technique, changing in choice of treatment technique, reduction in working hour, reduction in number of patients being treated, quitting the jobs etc as a result of the work-related condition. Hence this problem cannot be ignored. Objective: The main aim of this study was to determine the prevalence of thumb pain in Physiotherapists practicing Manual therapy in Delhi-NCR in India and to determine its impact on the work. Methods: Cross sectional survey of 118 Physiotherapists practicing Manual therapy in Hospitals and manual therapy clinics in Delhi-NCR in India was conducted and descriptive data for age, gender, handedness, years of experience, working hours per week, manual therapy techniques used, thumb pain measurement on VAS and its consequences on work were obtained. Results: The prevalence of thumb pain was observed as 38.98% that had following impact on work practice of physiotherapists: 32.61% changed the implementation of their treatment techniques, 32.61% changed the choice of their treatment techniques, 15.22% decreased their number of patients for treatment in daily routine, 10.87% reduced their working hours and 8.70% decreased the use of manual technique. Conclusions: In this study, incidence of thumb pain was low (38.98%) in Physiotherapists who practice manual therapy and the most important consequence was change in choices and implementation of treatment technique.
South African Journal of Physiotherapy, 2015
Research question: What is the prevalence of and factors associated with work-related thumb problems (WRTP) in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques?Design: A cross-sectional, descriptive study design was used and data were collected using two Internet-based questionnaires.Participants: The 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 measures: The variables measured included demographic, employment, educational and occupational factors.Results: The 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 significa...
Effects of taping on thumb alignment and force application during PA mobilisations
Manual Therapy, 2011
Work related thumb pain (WRTP) is a major problem among manipulative physiotherapists. Therapists who maintain the thumb joints in an extended alignment during PA mobilisation experience less WRTP. The purposes of this study were to investigate what effect taping of the thumbs has on thumb alignment during mobilisation and to gain normative data on the mobilisation forces applied by student physiotherapists. Forty final year student physiotherapists participated and were asked to apply a grade III PA mobilisation onto the C7 vertebra of one of 32 asymptomatic models. Participants were then instructed to apply the same mobilisation onto a force measurement instrument, in both the tape and no tape conditions, while the alignment of their metacarpophalangeal (MCP) and interphalangeal (IP) joints was noted via video recorder. Thumb alignment improved in 72.5% of participants post taping, with significant increases in the number of MCP joints maintained in a neutral alignment (p < 0.05). The mean peak mobilisation force applied by the students was 70.9 N. Taping of the thumbs prior to PA mobilisation improved thumb alignment during mobilisation in this cohort of undergraduate students, thus potentially influencing one of the contributory factors to WRTP.
Pressures Generated During Spinal Manipulation and Their Association With Hand Anatomy
Journal of Manipulative and Physiological Therapeutics, 2005
Background Context: The role of the variation in the application manipulation itself is largely unknown. A greater understanding of its input parameters is necessary to better understand spinal manipulation outcomes. Purpose: The objective of this study is to determine if pressures generated during manipulation are altered by hand configuration.
Biomedica, 2023
Background and Objective: Manual therapy is a treatment approach by physical therapists where different techniques are applied to patients with hands for rehabilitation purposes. The objective of the study was to find the frequency of De'Quervain tenosynovitis and thumb and wrist pain in physical therapists working in different rehabilitation centers in relation to age, body mass index (BMI), and working hours. Methods: A cross-sectional study was conducted on 135 physical therapists working in different settings in Lahore, Pakistan. Physiotherapists were enrolled by convenience sampling. Data were recorded on a questionnaire form. Finkelstein test was performed to check De Quervain's tenosynovitis. A numeric pain rating scale was sued to measure pain. The data were tested for significance using statistical tests. Results: On the dominant hand, 99 (73.3%) physical therapists had no wrist pain, 104 (77%) had no thumb pain, 28 (20.7%) had mild wrist pain and 20 (14.8%) had mild thumb pain. Only 21 (15.6%) physiotherapists were tested positive for Finkelstein (De Quervain's tenosynovitis). Finkelstein test reported 100% negative result on the non-dominant side. There is a negative correlation between thumb pain with the age (r =-0.005), BMI (r =-0.110) and working hours (r =-0.033) of the physical therapists. Conclusion: The study concluded that the prevalence of De Quervain's tenosynovitis, thumb, and wrist pain was more on the dominant hand than on the non-dominant side. The majority of the physical therapists reported mild to no pain in the wrist and thumb. There is a negative correlation of thumb pain with age, BMI and working hours.
Journal of Manipulative and Physiological Therapeutics, 2007
Purpose: High volumes of manual therapy work can lead to overuse hand and wrist injuries. This study evaluated hand and back comfort in asymptomatic volunteers during spinal mobilization carried out with an instrumented manual therapy tool. Methods: This crossover design study examined 36 asymptomatic physiotherapy students that were tested in pairs. One participant assumed the role of the simulated therapist and the other the simulated patient, before reversing roles. Posteroanterior mobilization conditions formed by using 2 spinal segments (thoracic/ lumbar), 2 force application methods (hands/device), and 3 grades of mobilization were applied in a random order. After each combination, both participants in each pair rated hand or back comfort, respectively, on a 100-mm visual analogue scale. Data were analyzed by analysis of variance. Results: Rated back comfort was greater for hands than for the device and decreased with greater applied force. When the original hard rubber device tip was changed to one of soft molded rubber, both back and hand comfort improved significantly. Although tool mobilization was still rated as significantly less comfortable than mobilization with hands only, this difference was approximately half the discomfort experienced as the grade of mobilization increased from grade I to grade III. For hand comfort when using the softer device tip, the method of force application was no longer a significant determinant of comfort. Conclusions: The mobilizing tool with a molded rubber tip was acceptably comfortable in use with asymptomatic backs and hands. Further research is indicated in manual therapy settings with therapists who have experienced hand pain.
Current practice patterns in conservative thumb CMC joint care: Survey results
Journal of Hand Therapy, 2014
Study design: Cross-sectional descriptive survey Introduction: Best practice for conservative clinical care pathways is not well outlined in the literature for patients with thumb carpometacarpal joint (CMCJ) pain. This self-report survey investigated the current practice patterns of assessments and conservative interventions for the painful thumb CMCJ among hand therapists. Methods: An online survey was distributed to members of the American Society of Hand Therapists (ASHT). Questions were included about evaluation measures and intervention techniques used for this population. A descriptive analysis was completed of the results. Results: A total of 23.5% of the ASHT membership responded to the survey. Results were categorized using the International Classification of Functioning and Disability domains as a framework. The survey results report varying use of evaluation measures, therapeutic interventions, including orthotic fabrication, joint protection and patient education all therapeutic interventional techniques, and modalities. Conclusion: Therapists use a comprehensive array of evaluation measures and interventions for body functions and structures in the care of thumb CMC pain. In contrast, more consistent use is needed of psychometrically-sound functional outcome measures that show change in activities and participation. This survey highlights areas to employ current evidence, as well as, future research should address environmental factors and personal factors for this population Level of evidence: Not applicable.