WORK PARTICIPATION OF PATIENTS WITH MUSCULOSKELETAL DISORDERS: IS THIS ADDRESSED IN PHYSICAL THERAPY PRACTICE?

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Oswald W1,2, Hutting N1, Engels JA1, Staal JB3,4, Nijhuis-van der Sanden MWG4, Heerkens YF1
1HAN University of Applied Sciences, Research Group Occupation & Health, Nijmegen, Netherlands, 2HAN University of Applied Sciences, Faculty of Health and Social Studies, Physiotherapy, Nijmegen, Netherlands, 3HAN University of Applied Sciences, Faculty of Health and Social Studies, Research Group Musculoskeletal Rehabilitation, Nijmegen, Netherlands, 4Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands

Background: Musculoskeletal disorders (MSDs) are the main complaints for visiting a physical therapist (PT) in primary health care. MSDs have a negative effect on an individual´s quality of life and result in a major cost to society. Qualitative research has shown that physical therapists (PTs) treating patients with MSDs experience barriers in the integration of occupational factors within their practice, and also revealed a lack of cooperation between PTs and (other) occupational healthcare providers. Although generalist PTs treat working-age patients with MSDs, they may hesitate to include occupational factors in their treatment, irrespective of whether or not they found work an important factor. However, generalist PTs can play an important role in facilitating return to work and prevention of absenteeism.

Purpose: The purpose of this study is to quantitatively investigate how PTs in the Netherlands currently integrate occupational factors within their practice, and identify their opinions and needs with regard to enhancing the integration of the patient's work within physical therapy.

Methods: A cross-sectional survey was conducted among generalist PTs who treat working-age (18-67 years) patients with MSDs. Generalist PTs were contacted for participation via digital news-mails and asked to fill out an online survey which was developed based on the results of a recent qualitative study. The survey consisted of: i) demographics of the participants, ii) questions on how generalist PTs currently integrate occupational factors within their practice, and iii) questions on their opinion about the integration of occupational factors within physical therapy. The PTs were also asked about their needs with regard to the integration of occupational factors and with regard to cooperation with other (occupational) health professionals.

Results: Of the 142 respondents, 64% indicated that occupational factors should be addressed to a greater extent within physical therapy. To have the possibility to bill for a workplace assessment (60.6%) and more knowledge about laws and regulations (50%) were identified as needs of the respondents. Only 14.8% of the respondents indicated that they communicate with or consult a PT specialized in occupational health and 24.3% rarely or never consult their specialized colleague. Only 12.7% of the participants who do not have a specialized colleague sometimes/regularly refer patients to a specialized PT.

Conclusion(s): Although generalist PTs address occupational factors within their practice, there is room for improvement. This study also identified a lack of cooperation between generalist PTs and PTs specialized in occupational health.

Implications: Although PTs were aware of the importance of integrating occupational factors within their practice, it seems that a more systematic approach to obtain insight into occupational factors by means of questionnaires, observations, and workplace visits could increase effectiveness. It seems valuable to support and facilitate generalist PTs in addressing these occupational factors more extensively in their practice. Future interventions should focus on enhancing the cooperation between PTs who treat patients with MSDs and work related physical therapists in order to create consulting facilities and faster referral. The results of this study can also be used to develop interventions aimed at facilitation of the integration of occupational factors within physical therapy practice.

Keywords: Work participation, Musculoskeletal disorders, Physical therapy practice

Funding acknowledgements: This study was funded by the Scientific College Physical Therapy (WCF) of the Royal Dutch Society for Physical Therapy (KNGF).

Topic: Occupational health & ergonomics; Musculoskeletal; Professional issues

Ethics approval required: No
Institution: HAN University of Applied Sciences
Ethics committee: Medical Ethical committee at the HAN University of Applied Sciences
Reason not required: The study (Registration no. ACPO 09.01/16) does not fall within the Dutch law on Medical Research involving Human Subjects.


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