WHAT SHOULD PHYSIOTHERAPISTS DO TO FACILITATE THE REHABILITATION OF PEOPLE WITH MUSCULOSKELETAL DISORDERS AFFECTING THEIR WORK PARTICIPATION?  A SCOPING REVIEW

M. St-Georges1,2, A. Hudon1,2,3
1Université de Montréal, School of Rehabilitation, Montréal, Canada, 2Center for Interdisciplinary Research in Rehabilitation (CRIR), Montreal, Canada, 3Ethics Research Center (CRÉ), Montréal, Canada

Background: Musculoskeletal disorders (MSDs) and work-related musculoskeletal disorders (WRMSDs) are the cause of prolonged disability and can significantly impede the work participation of those affected.  As physiotherapists are often involved in the rehabilitation of people having sustained such injuries, they need to possess the necessary competencies to support their patients in reintegrating their work. However, this area of practice is not thoroughly covered in most physiotherapy entry-level curricula, and specific competencies regarding this domain need to be better defined.

Purpose: Our objective was 1) to identify literature that specifically addresses competencies that physiotherapists need to demonstrate in order to facilitate the rehabilitation, return to work and work participation of people with a MSD or a WRMSD; and 2) to identify potential research and practice gaps in this area.

Methods: We conducted a scoping review following the five-step method recommended by Arksey & O’Malley. The following broad categories of keywords were used: 1) physiotherapy; 2) return to work or occupational health and 3) education, in Embase, Medline and CINAHL on May 11, 2020. Both authors reviewed the full text papers and agreed on the selection of articles for inclusion. We included French and English articles focusing on competencies physiotherapists must develop to help working-age patients suffering from MSDs or WRMSDs return to or participate in work. Exclusion criteria were: 1) articles only related to primary prevention; 2) on-site physiotherapy and 3) interventions for a specific disease. The included articles were then charted in an Excel grid and subsequently thematically analyzed.

Results: Thirty-four articles were included in the results. According to these, competencies physiotherapists need to possess in order to adequately support the return to work and work participation of their patients are : assessing readiness for work, addressing potential psychological barriers, providing patients with education on their condition, assessing the workplace, using a problem-solving approach to resolve barriers to rehabilitation and creating links with the employer and the insurer to facilitate rehabilitation. Many articles also recommended more emphasis to be put on work-related content in the physiotherapy curricula and to provide more opportunities for physiotherapists to practice and gain experience in this area. Finally, one important gap identified in the results concerns the identification and selection of the most appropriate tools (e.g., validated questionnaires) to support physiotherapists in their work-related practice.

Conclusion(s): The articles analyzed in this scoping review allowed to delineate strong work-related practice competencies for physiotherapists treating working-age adults with MSDs or WRMSDs. Further research should focus on how these competencies can be better addressed within physiotherapists training in the future. Future research could also develop an overview of existing tools that could help physiotherapists in their work-related practice and assess their validity in the clinical context.

Implications: Findings from this scoping review will help inform physiotherapy educators and clinicians about the important competencies physiotherapists should possess to help patients return to or participate in work.  We hope that by improving physiotherapists’ competencies in this domain, this will ultimately improve care and facilitate sustainable return to work and work participation for the working population.

Funding, acknowledgements: Mélodie St-Georges received a PREMIER bursary from the University of Montreal to complete this study.

Keywords: Return to Work, Work Rehabilitation, Competencies

Topic: Occupational health & ergonomics

Did this work require ethics approval? No
Institution: N/A
Committee: N/A
Reason: Scoping-review is a form of review of the litterature and, as a systematic review, do not required ethics approval.


All authors, affiliations and abstracts have been published as submitted.

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