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      Work-related acute physical injuries, chronic overuse complaints, and the psychosocial work environment in Danish primary care chiropractic practice – a cross-sectional study

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          Abstract

          Background

          Little is known about the physical and psychosocial work environment of chiropractors and their work-related health complaints, and this has never been described for Danish chiropractors. The aim of this study was, therefore, to describe work-related acute physical injuries, overuse complaints, and psychosocial stress in Danish chiropractic work settings.

          Methods

          We developed a questionnaire specifically for this study and distributed it electronically in August 2016 using SurveyXact to all 575 members of the Danish Chiropractors’ Association working in primary care clinics. Chiropractors were asked about their work-related acute physical injuries and overuse complaints as well as any psychosocial stress they experienced at work during the previous year. We described our sample and variables using means, medians, ranges, and confidence intervals where appropriate. Statistically significant differences between genders, types of complaints and injuries, and between clinic owners and associates were examined using Chi-square and Fischer’s exact tests, where appropriate, or by examining confidence intervals for non-overlap.

          Results

          355 (65.2%) chiropractors answered the survey. Of these, 216 (61%, 95% CI 56–66) had experienced a work-related acute physical injury and/or overuse complaint during the previous year. Work-related overuse complaints were most commonly reported in the low back, wrist, thumb, and shoulder, and were more common among women (63%, 95% CI 56–70) than men (51%, 95% CI 43–59). Chiropractors with more than five years in practice (59%, 95% CI 52–64) reported significantly fewer work-related acute injuries and overuse complaints during the previous year compared with chiropractors with less than five years in practice (83%, 95% CI 73–91). In general, these practicing Danish chiropractors reported having a good psychosocial work environment, and 90% of chiropractors “always” or “often” felt that they were motivated and committed to their work.

          Conclusion

          This sample of Danish practicing chiropractors commonly reported work-related acute physical injuries or overuse complaints. Overuse complaints were most commonly reported in the low back, wrist, thumb, and shoulder and were more common among women than men. Newly educated chiropractors reported more overuse complaints than experienced chiropractors. Collectively, this sample of Danish chiropractors reported that they had a good psychosocial work environment.

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          Most cited references10

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          Cause, prevalence, and response to occupational musculoskeletal injuries reported by physical therapists and physical therapist assistants.

          Physical therapists (PTs) and physical therapist assistants (PTAs) are susceptible to occupational musculoskeletal injuries. The purpose of this study was to examine the reported causes and prevalence of occupational musculoskeletal injuries to PTs and PTAs during a 2-year period. A questionnaire was mailed to 500 PTs and 500 PTAs randomly selected from the American Physical Therapy Association 1996 active membership list. Six hundred sixty-seven questionnaires were returned, giving a response rate of 67%. Based on a literature review and a pilot study, an occupational injury questionnaire was constructed and mailed. Self-reports of injuries were obtained. Thirty-two percent of the PTs and 35% of the PTAs reported sustaining a musculoskeletal injury. The highest prevalence of injury was to the low back (62% of injured PTs and 56% of injured PTAs). The PTs reported the upper back and the wrist and hand as having the second highest prevalence (23%). The PTAs reported the upper back as having the second highest prevalence (28%). The PTs and PTAs reported making changes in their work habits of improved body mechanics, increased use of other personnel, and frequent change of work position. The majority of PTs and PTAs reported they did not limit patient contact time or area of practice after sustaining an injury. Although PTs and PTAs are recognized to be knowledgeable in prevention and treatment of musculoskeletal injuries, they are susceptible to sustaining occupational musculoskeletal injuries because of performing labor-intensive tasks.
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            Work-related musculoskeletal disorders among physical therapists: A systematic review.

            Physical therapists (PTs) perform demanding tasks that can lead to work-related musculoskeletal disorders (WMSD), but the rates and characteristics of WMSD among PTs are not well known. The objective of this systematic review of the literature was to integrate the information published on the prevalence, types, and risks for WMSD among PTs. Four databases were searched using combinations and synonyms for WMSD, discomfort, symptoms, and PTs. Two reviewers independently searched and screened peer-reviewed articles published in English evaluating WMSD in PTs; agreement between reviewers was evaluated. From 867 unduplicated articles, 32 were eligible and included. Up to 90% of PTs have WMSD during their careers; 50% experience WMSD within 5 years of practice. Low back was the body part most commonly affected. Female PTs and PTs working in hospitals have higher prevalence of WMSD. WMSD are associated with PTs' age, gender, specialty and job tasks. Performing manual therapy, lifting and transferring patients are tasks commonly associated with PTs' developing WMSD. The body parts affected differed by specialty and tasks. The findings presented in this review are useful to inform future research, quality improvement, and educational programs to reduce the rates of WMSD among PTs.
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              Work-related injuries of doctors of chiropractic in the United States.

              This study was undertaken to determine the prevalence and types of work-related injuries among a nationwide sample of chiropractors and to identify factors associated with these injuries. Using a survey, 1000 randomly selected doctors of chiropractic in the United States were asked to record their 3 most serious injuries. Details were obtained about the type of injury, area of the body affected, activity performed at that time, year of practice when the injury had occurred, if the doctor had needed to take time off from work, and what they had changed as a result of the injury. A total of 422 responses were obtained (42.2%), yielding 397 usable surveys. One hundred fifty-nine chiropractors (40.1%) reported experiencing a total of 252 injuries while working. Most injuries were classified as soft tissue injuries and occurred while either performing (66.7%) or positioning (11.1%) a patient for manipulation. Body parts most commonly injured were the wrist/hand/finger (42.9%), shoulder (25.8%), and low back (24.6%). The anatomic areas of the patient being manipulated in which the doctor was injured were the lumbosacral (37.1%) and thoracic spine (21.6%). Shoulder (P < .001) and low back (P < .001) injuries were significantly more likely to have been caused by adjustments of the lumbosacral spine with the patient in the side-lying position. Most commonly, injuries occurred in the first to fifth year of practice (37.3%). Of note, 5.4% of injuries reported occurred while attending chiropractic college. A high prevalence of upper extremity injuries was reported in the group surveyed. These injuries were most often related to side-posture manipulation to the lumbar spine. Because most injuries occurred early on in the career and required a change in technique, greater efforts toward injury prevention education should be aimed toward chiropractic students.
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                Author and article information

                Contributors
                millecharlotte@hotmail.com
                tinefisk@gmail.com
                h.wulff@nikkb.dk
                jhartvigsen@health.sdu.dk
                Journal
                Chiropr Man Therap
                Chiropr Man Therap
                Chiropractic & Manual Therapies
                BioMed Central (London )
                2045-709X
                13 February 2018
                13 February 2018
                2018
                : 26
                : 4
                Affiliations
                [1 ]Private practice of chiropractic, Ballerup, Denmark
                [2 ]ISNI 0000 0001 0728 0170, GRID grid.10825.3e, Department of Sports Science and Clinical Biomechanics, , University of Southern Denmark, ; Campusvej 55, DK-5230 Odense M, Denmark
                [3 ]ISNI 0000 0004 0402 6080, GRID grid.420064.4, Nordic Institute of Chiropractic and Clinical Biomechanics, ; Campusvej 55, DK-5230 Odense M, Denmark
                Article
                174
                10.1186/s12998-018-0174-2
                5809813
                b92e3bbd-e56f-4133-8768-d349cf3b984d
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 16 August 2017
                : 5 January 2018
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                Complementary & Alternative medicine
                chiropractic,work-related,injuries,psychosocial,stress,overuse,complaints

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