Understanding Work-Related Injury Risk Among Rural Rehabilitation Clinicians

Abstract

Background: Rehabilitation clinicians have a high risk of occupational injury. Work-related musculoskeletal disorders (WMSDs) are one of the most frequent injuries for rehabilitation clinicians due to repeated heavy lifting and other forceful tasks. The primary objective of this study was to identify factors that caused or contributed to WMSDs for clinicians specifically working in rehabilitation settings (e.g., acute care, inpatient rehabilitation, long-term care, outpatient therapy). Methods: An, in person, proctored questionnaire was conducted of physical therapists (PTs), occupational therapists (OTs) and therapy assistants working at a rural community hospital. Information on general workload, work-related pain or discomfort, patient handling, and clinical experience were gathered using both a scripted interview questionnaire and a semi-scripted post-interview discussion. The questionnaire was analyzed using both descriptive and inferential statistical methods to determine the 1-year prevalence of WMSDs and factors associated with WMSDs and use of safe patient handling techniques. Results: Respondents (n=27) included 18 PTs, 6 OTs and 3 therapy assistants. On average, rehabilitation clinicians spent over eight hours per day delivering “hands-on” care to patients. During a typical workday, therapists spent more than 20% performing heavy lifting, physically fatiguing tasks, or were in a static or awkward posture. Bending or twisting, repetitive tasks, and kneeling or squatting were each performed 30% or more of a typical workday, especially bending or twisting (38%). More than half (63%) suffered musculoskeletal pain/discomfort during the past year. Inadequate lifting devices were reported to be available in the working environment. A negative association was observed between the availability of multiple lifting devices and WMSDS (p-values<0.05). Less than a third of clinicians (31.5%) reported complete confidence to use mechanical lifting devices during rehabilitation activities. Conclusion: Rehabilitation clinicians are at higher risk for WMSDs due to patient handling tasks. More ongoing training must be provided to ensure clinicians have confidence to use the technologies available for rehabilitation tasks. However, additional research is still needed to understand the causal factors of WMSDs related to patient handling, particularly for rural care settings that lack access to technology and adequate staffing.