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Selçuk Sağlık Dergisi, Cilt 4/Sayı 2/2023
Journal of Selcuk Health, Volume 4/Issue 2/2023
Research Article
INVESIGAT ION OF WORK-RELATED MUSCULOSKELETAL PAIN
IN PHYSIOTHERAPISTS: A CROSS-SECTIONAL STUDY
Fatih ÖZYURT
1
, Sinan TUNA
2
, Cihan Caner AKSOY
3
Abstract
Aim: Musculoskeletal pain (MSP) can be defined as a feeling of discomfort arising from bones,
tendons, ligaments or muscles. MSP is more common in some healthcare professionals. Among
healthcare professionals, physiotherapists are also at a higher risk for MSP. The aim of this
study is to compare the MSPs of physiotherapists working with different patient types.
Method: We recruited 110 physiotherapists who met the inclusion and exclusion criteria.
Physiotherapists with rheumatic disease-causing MSP were excluded. Participants were
contacted online between June-August 2020. MSP of the participants was evaluated with the
Cornell Musculoskeletal Disorder Questionnaire. The statistical significance level was set as
p<0.05.
Findings: We recruited a total of 110 physiotherapists (26.2±3.1 age). While physiotherapists
recruiting pediatric patients work in private institutions, orthopedic and neurological patients
work in public institutions(p<0.001). Job satisfaction(p=0.011), neck area score(p=0.002), right
wrist score(p=0.016), back score(p=0.011), low back score(p=0.014), right upper leg
score(p=0.034) among physiotherapists who received different patient types scores were
different.
Results: Physiotherapists recruiting pediatric patient groups work in the private sector.
Physiotherapists receiving orthopedic patient group have higher job satisfactionlevels.
Physiotherapists in the neurological patient group had higher scores on the right wrist, back,
lower back and right upper leg in work-related MSP.
Keywords: Job satisfaction; Musculoskeletal pain; Neurological; Orthopedic; Physiotherapist.
1
: Arş. Gör., Kırşehir Ahi Evran Üniversitesi, Fizik Tedavi ve Rehabilitasyon Yüksekokulu, Kırşehir, Türkiye,
fatih.ozyurt10@gmail.com, ORCID: 0000-0002-0201-9798
2
Sinan TUNA, Kütahya Sağlık Bilimleri Üniversitesi, Lisansüstü Eğitim Enstitüsü, Fizyoterapi ve
Rehabilitasyon Anabilim Dalı, Kütahya, Türkiye, sinantuna@outlook.com, ORCID: 0000-0003-2735-
5955
3
Cihan Caner AKSOY, Kütahya Sağlık Bilimleri Üniversitesi, Sağlık Bilimleri Fakültesi, Fizyoterapi ve
Rehabilitasyon Bölümü, cihancaner.aksoy@ksbu.edu.tr, ORCID: 0000-0003-0538-3613
Received: 06.07.2023
Accepted: 21.08.2023
Cite for: Özyurt, F., Tuna, S., Aksoy, C.C., (2023). Fizyoterapistlerde İşe Bağlı Kas İskelet Sistemi Ağrılarının
Araştırılması: Kesitsel Çalışma. 4(2), 305 – 320.
Selçuk Sağlık Dergisi, Cilt 4/Sayı 2/2023
Journal of Selcuk Health, Volume 4/Issue 2/2023
Fizyoterapistlerde İşe Bağlı Kas İskelet Sistemi Ağrılarının Araştırılması:
Kesitsel Çalışma
Öz
Amaç: Kas-iskelet sistemi ağrısı (KİSA), kemikler, tendonlar, bağlar veya kaslardan
kaynaklanan bir rahatsızlık hissi olarak tanımlanabilir. KİSA, bazı sağlık profesyonellerinde
daha yaygın gözükmektedir. Sağlık profesyonelleri arasında fizyoterapistler de KİSA
bakımından yüksek risk altındadır. Bu çalışmanın amacı, farklı hasta tipleri ile çalışan
fizyoterapistlerin KİSA karşılaştırmaktır.
Yöntem: Dahil edilme ve dışlama kriterlerini karşılayan 110 fizyoterapist çalışmaya dahil
edildi. Romatizmal hastalığa neden olan KİSA’lı fizyoterapistler çalışma dışı bırakıldı.
Katılımcılarla Haziran-Ağustos 2020 tarihleri arasında online olarak iletişime geçildi.
Katılımcıların KİSA’ları Cornell Kas-iskelet Bozuklukları Anketi ile değerlendirildi.
İstatistiksel anlamlılık düzeyi p<0,05 olarak belirlendi.
Bulgular: Toplam 110 fizyoterapist (26.2±3.1 yıl) dahil edildi. Pediatrik hasta alan
fizyoterapistler özel kurumlarda çalışırken, ortopedik ve nörolojik hasta alanlar kamu
kurumlarında çalışmaktadır(p<0,001). İş doyumu(p=0,011), boyun bölgesi skoru(p=0,002), sağ
bilek skoru(p=0,016), sırt skoru(p=0,011), bel skoru(p=0,014), sağ üst bacak skoru(p=0,034)
farklı hasta tipi ile çalışan fizyoterapistler arasında farklılık saptanmıştırmerkezi ve kesinlik alt
boyutları ile arasında negatif, sağlığın önemi ve öz farkındalık alt boyutlarıyla ise pozitif yönlü
ve anlamlı ilişkinin mevcut olduğu görülmektedir (p<0,05).
Sonuç: Pediatrik hasta grupları ile çalışan fizyoterapistler özel sektörde çalışmaktadır.
Ortopedik hasta grubu ile çalışan fizyoterapistlerin iş doyum düzeyleri daha yüksektir.
Nörolojik hasta grubundaki fizyoterapistlerin işle ilgili KİSA sağ bilek, sırt, bel ve sağ üst bacak
puanları daha yüksek saptanmıştır.
Anahtar Kelimeler: İş doyumu; Kas-iskelet ağrısı; Nörolojik; Ortopedik; Fizyoterapist.
Selçuk Sağlık Dergisi, Cilt 4/Sayı 2/2023
Journal of Selcuk Health, Volume 4/Issue 2/2023
1.INTRODUCTION
Musculoskeletal pain (MSP); It can be defined as a feeling of discomfort arising from bones, tendons,
ligaments or muscles (Gómez-Rodríguez et al., 2020). his type of pain not only diminishes an
individual's quality of life but also has negative effects on their overall well-being from a
biopsychosocial perspective. While MSP typically becomes more common with age as a natural
consequence of aging, it can also affect younger individuals due to factors such as repetitive movements,
traumas, or occupations involving heavy physical work (Silva Guerrero et al., 2018).
Various factors contribute to the development of musculoskeletal pain (MSP) in the workplace,
including biomechanical errors, inadequate equipment to support proper biomechanics, repetitive
movements, prolonged static posture, excessive use, and long working hours (Duray & Yağci, 2017).
MSP is particularly prevalent in certain occupational groups, with healthcare workers being among the
most affected. Within the healthcare profession, physiotherapists, occupational therapists, and nurses
are at a higher risk of experiencing musculoskeletal problems (Atlı et al., 2020). Physiotherapy, as one
of these professions, involves treatment approaches such as manual therapy, electrophysical agents, and
exercise training, which can lead to physical strain and demanding postures. Physiotherapists are
particularly susceptible to MSP due to the inherent conditions of their job. Studies have reported a high
incidence of MSP, especially among physiotherapists working with severe neurological and orthopedic
patient groups (Nordin et al., 2011).
In a study investigating the occurrence of musculoskeletal pain (MSP) among physiotherapists based on
their employment status in public or private institutions, it was found that the prevalence of MSP was
lower among those working in public institutions compared to those in private institutions. This
difference was attributed to variations in working hours and conditions(Korkulu & Kolçak, 2019). In a
study examining the occurrence of musculoskeletal pain (MSP) among physiotherapists based on their
employment status in public or private institutions, it was found that the prevalence of MSP was lower
among those working in public institutions compared to those in private institutions. This difference was
attributed to variations in working hours and conditions. In the picture that emerges, Taken together,
MSP causes both tangible and intangible challenges for physiotherapists, including reduced quality of
life, decreased workforce efficiency, and increased healthcare expenses(Iqbal & Alghadir, 2015).
In the literature, there are many studies investigating MSP in different health professions. However, the
number of studies investigating MSP in physiotherapists is quite limited. Therefore, the aim of this study
is to examine the presence of MSP in physiotherapists working in different patient groups. The
hypothesis of this study is that the musculoskeletal pain of physiotherapists working in different patient
groups is different.
Selçuk Sağlık Dergisi, Cilt 4/Sayı 2/2023
Journal of Selcuk Health, Volume 4/Issue 2/2023
2. METHODS
2.1 Study design and setting
This study was planned as a cross-sectional study. Study data were collected online from June to August
2020. This study was approved by the Non-Interventional Ethics Committee of Kütahya Health Sciences
University with the decision numbered 2020/05. Physiotherapists actively working in Turkey the sample
of the study. Social media tools were used to reach the sample.
2.2 Procedure
The forms to be used in the study were transferred to electronic media. Physiotherapists who were
interested in participating in the study accessed the study forms through Google Forms, which were
promoted via announcements on social media platforms and messaging applications commonly used by
physiotherapists. The first page of the form provided detailed information about the study. Participants
were directed to the section containing the scales after indicating their agreement to participate by
checking the corresponding box. Physiotherapists who chose not to participate were directed to a thank
last page, and their data was not recorded. The first section of the questionnaire focused on gathering
sociodemographic information from the participants. Subsequently, the Cornell Musculoskeletal
Discomfort Questionnaires and questions related to working conditions were presented.
2.3 Participants
The study included participants who had graduated from the physiotherapy and rehabilitation
department, were actively working in their job, and volunteered to participate. Individuals with
rheumatic diseases such as ankylosing spondylitis or rheumatoid arthritis, which could potentially
contribute to musculoskeletal pain, were excluded from the study. (Khan & Fasih, 2017).
2.4 Outcome
2.4.1 Sociodemographic Information
In the sociodemographic information of the participants; age (in years), gender, height (ib-n
centimeters), body weight (in kilograms), regular exercise habit (at least 3 days a week at least 30
minutes of exercise) (answered as yes or no), information about the institution, professional experience
(years), smoking and alcohol use (answered as yes or no). Additionally, participants were asked about
the type of patients they treat (Fuat & Seda, 2021).
2.4.2 Job related questions
In addition to the previous sociodemographic information, the participants were asked about their work
schedule, including the number of days worked per week and the number of hours worked per day. The
number of patients they treated was also queried. Participants were asked about the general patient group
they typically treated (Fuat & Seda, 2021). Furthermore, the participants were asked to assess whether
Selçuk Sağlık Dergisi, Cilt 4/Sayı 2/2023
Journal of Selcuk Health, Volume 4/Issue 2/2023
they found the working conditions in their institutions to be ergonomic. If they responded negatively,
they were asked to provide the reason for their response. Lastly, participants were asked to rate their job
satisfaction on a scale from 0 to 10, with "0" indicating no satisfaction at all and "10" indicating complete
satisfaction with their job (Yakut & Yakut, 2011).
2.4.3 Cornell Musculoskeletal Discomfort Questionnaires
Musculoskeletal pain of the individuals participating in the study was evaluated with the Cornell
Musculoskeletal Discomfort Questionnaire. The questionnaire questions the frequency and severity of
pain in various body parts and whether it interferes with the ability to do work. Participants are asked to
mark different pain areas or regions on the scale. While the scale is transferred to Google Forms, there
are questions about different body parts on each page. In the scale, how often he felt pain in the last
week, using a 5-point Likert scale (1-never, 2- one-two times/week, 3- three-four times/week, 4-once
every day, 5-several times every day) pain intensity on a 3-point Likert scale (1- Sligthly, 2-Moderately,
3-Very uncomfortable) and whether or not the pain interfered with the work on a 3-point Likert scale
(1-Not at all, 2-slightly, 3-substantially intereference) are being investigated. The score of the scale was
obtained by multiplying the frequency of pain, the severity of pain and the level of disability (Erdinc et
al., 2011). The scale score can be 0-90 points for each region according to the scoring system. A high
score indicates a high disability level for the relevant region. Erdinç et al. Turkish validity and reliability
study of the scale was conducted in 2011 (Erdinc et al., 2011). The Cronbach Alpha value of the three
sub-headings of the questionnaire, namely frequency of pain, severity and disability, was 0.88,
respectively; 0.89 and 0.88 (Fuat & Seda, 2021).
2.5 Sample size
G*PowerSoftware (ver. 3.1.9.2, Düsseldorf, Germany) program was used to calculate the number of
samples to participate in our study. In an article using Cornell Musculoskeletal System scoring in
physiotherapists, the mean and standard deviations of the back scores between male and female genders
were taken as reference and analyzed using t tests. The analysis was performed at 80% power, 0.50
margin of error and 0.5 effect size. As a result of the analysis, a total of 86 people were planned to
participate in the study (Fuat & Seda, 2021). Considering that missing data will emerge during the
evaluation, it was planned to include 104 people in the study by giving a 20% reduction margin.
2.6 Statistical analysis
SPSS® (ver. 22.0; IBM Corp., NY, USA) was used for data analysis. Variables were analyzed using
visual (probability plots, histograms) and analytical methods Kolmogorov-Smirnov to distinguish
whether the data were normally distributed. Relationships between categorical variables were compared
with Chi-square or Fisher Exact test comparison test. Parametric tests were used for normal distribution
Selçuk Sağlık Dergisi, Cilt 4/Sayı 2/2023
Journal of Selcuk Health, Volume 4/Issue 2/2023
data and non-parametric tests were used for non-normally distributed data. Values for continuous
variables were expressed in terms of mean ± standard deviation (mean±SD), standard mean error (SEM),
and confidence intervals (95% CI). Values for categorical variables were expressed as proportional (%).
The Spearman correlation analysis was used to correlate the data between the variables examined.
Kruskal Wallis Test and Bonferoni post-hoc test were used to compare 3 or more groups. Statistical
significance level was set as p<0.05 (Songül et al., 2021).
3. RESULT
A total of 136 individuals participated in the study, consisting of 80 women and 56 men. However, 26
participants were excluded from the analysis due to missing data. The data from 110 participants were
included and analyzed in our study. Table 1 presents the descriptive characteristics of the participating
physiotherapists. Among the participants, 46 (41.8%) were male and 64 (58.2%) were female. In terms
of patient groups, 23 (20.9%) physiotherapists treated orthopedic patients, 24 (21.8%) treated
neurological patients, 25 (22.7%) treated pediatric patients, and 38 (34.5%) treated a mixed patient
population.
Table 1. Descriptive characteristics of physiotherapists (N=110)
X±SD/n(%)
Sex
Male
46 (41.8)
Female
64 (58.2)
Age (years)
26.2±3.1
BMI (kg/m2)
22.32±2.96
Type of institution
Public (University Hospital- State Hospital)
45 (40.9)
Private (Special Education Center- Private Hospital)
65 (59.1)
Type of Patient Received
Orthopedic Patient
23 (20.9)
Neurological Patient
24 (21.8)
Pediatric Patient
25 (22.7)
Mixed Patient
38 (34.5)
Finding Working Conditions Ergonomic
Yes
28 (25.5)
No
82 (74.5)
Reasons for Not Finding the Working Conditions Ergonomic
Bed-Chair Lengths Fixed
31 (28.2)
Working in the Wrong Posture
7 (6.4)
Difficulty of Patient Type
10 (9.1)
Equipment-Device Lack- Physical Conditions of Working Condition
25 (22.7)
Others
37 (33.6)
Smoking
Yes
26 (23.6)
No
84 (76.4)
Alcohol Use
Yes
17 (15.5)
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Journal of Selcuk Health, Volume 4/Issue 2/2023
No
93 (84.5)
Regular Exercise Habit
Yes
22 (20.0)
No
88 (80.0)
Presence of Neck Pain
Yes
84 (76.4)
No
26 (23.6)
Presence of Right Shoulder Pain
Yes
49 (44.5)
No
61 (55.5)
Presence of Left Shoulder Pain
Yes
44 (40.0)
No
66 (60.0)
Presence of Right Upper Arm Pain
Yes
31 (28.2)
No
79 (71.8)
Presence of Left Upper Arm Pain
Yes
18 (16.4)
No
92 (83.6)
Presence of Right Forearm Pain
Yes
39 (35.5)
No
71 (64.5)
Presence of Left Forearm Pain
Yes
23 (20.9)
No
87 (79.1)
Presence of Right Wrist Pain
Yes
54 (49.1)
No
56 (50.9)
Presence of Left Wrist Pain
Yes
33 (30.0)
No
77 (70.0)
Presence of Back Pain
Yes
88 (80.0)
No
22 (20.0)
Presence of Low Back Pain
Yes
83 (75.5)
No
27 (24.5)
Presence of Hip Pain
Yes
33 (30.0)
No
77 (70.0)
Presence of Right Upper Leg Pain
Yes
19 (17.3)
No
91 (82.7)
Presence of Left Upper Leg Pain
Yes
19 (17.3)
No
91 (82.7)
Presence of Right Knee Pain
Yes
32 (29.1)
No
78 (70.9)
Presence of Left Knee Pain
Yes
32 (29.1)
No
78 (70.9)
Presence of Right Lower Leg Pain
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Journal of Selcuk Health, Volume 4/Issue 2/2023
Yes
18 (16.4)
No
92 (83.6)
Presence of Left Lower Leg Pain
Yes
19 (17.3)
No
91 (82.7)
Presence of Right Foot Pain
Yes
22 (20.0)
No
88 (80.0)
Presence of Left Foot Pain
Yes
17 (15.5)
No
93 (84.5)
Average Number of Patients Taken per Week
26.61±16.30
Job Experience (Year)
3.24±2.93
Number of Days Worked per Week
5.07±0.63
Hours Worked Per Day
7.99±0.69
Job Satisfaction
5.04±2.51
The most commonly reported areas of pain experienced by physiotherapists are as follows: 80% in the
back, 76.4% in the neck, and 75.5% in the low back. The region-specific scores for musculoskeletal pain
reported by the participants are provided in Table 2.
Table 2. Region-specific score of musculoskeletal pain
Region
X±SD
Neck
7.02±9.96
Right Shoulder
3.87±8.10
Left Shoulder
3.30±7.18
Right Upper Arm
1.47±4.41
Left Upper Arm
1.10±4.41
Right Wrist
6.71±17.87
Left Wrist
2.25±6.36
Back
11.89±17.23
Low back
11.21±19.46
Hip
1.95±7.21
Right Upper Leg
1.39±6.33
Left Upper Leg
1.47±6.36
Right Knee
2.13±5.95
Left Knee
2.22±7.06
Right Lower Leg
1.71±6.91
Left Lower Leg
1.79±6.89
Right Foot
1.75±7.57
Left Foot
1.38±5.81
Total
64.69±96.36
Selçuk Sağlık Dergisi, Cilt 4/Sayı 2/2023
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The comparison specific to the type of patient taken is given in Table 3.
Table 3. Comparison of qualitative data specific to the type of patient received
According to the Patient Group Received
Orthopedic Patient
(n=23)
Neurological Patient
(n=24)
Pediatric Patient
(n=25)
Mixed Patient
(n=38)
n(%)
n(%)
n(%)
n(%)
p
Sex
Male
15 (65.2)
8 (33.3)
8 (32.0)
15 (39.5)
0.073
Female
8 (34.8)
16 (66.7)
17 (68.0)
23 (60.5)
Type of institution
Public
17 (73.9)
18 (75.0)
0 (0)
10 (26.3)
<0.001
Private
6 (26.1)
6 (25.0)
25 (100)
28 (73.7)
Finding Working
Conditions Ergonomic
Yes
9 (39.1)
8 (33.3)
4 (16.0)
7 (18.4)
0.156
No
14 (60.9)
16 (66.7)
21 (84.0)
31 (81.6)
Presence of Neck Pain
Yes
18 (78.3)
20 (83.3)
14 (56.0)
32 (84.2)
0.052
No
5 (21.7)
4 (16.7)
11 (44.0)
6 (15.8)
Presence of Right
Shoulder Pain
Yes
9 (39.1)
14 (58.3)
9 (36.0)
17 (44.7)
0.414
No
14 (60.9)
10 (41.7)
16 (64.0)
21 (55.3)
Presence of Left
Shoulder Pain
Yes
9 (39.1)
11 (45.8)
7 (28.0)
17 (44.7)
0.531
No
14 (60.9)
13 (54.2)
18 (72.0)
21 (55.3)
Presence of Right
Upper Arm Pain
Yes
3 (13.0)
10 (41.7)
6 (24.0)
12 (31.6)
0.158
No
20 (87.0)
14 (58.3)
19 (76.0)
26 (68.4)
Presence of Left Upper
Arm Pain
Yes
3 (13.0)
6 (25.0)
4 (16.0)
5 (13.2)
0.619
No
20 (87.0)
18 (75.0)
21 (84.0)
33 (86.8)
Presence of Right
Forearm Pain
Yes
5 (21.7)
13 (54.2)
8 (32.0)
13 (34.2)
0.126
No
18 (78.3)
11 (45.8)
17 (68.0)
25 (65.8)
Presence of Left
Forearm Pain
Yes
2 (8.7)
8 (33.3)
6 (24.0)
7 (18.4)
0.203
No
21 (91.3)
16 (66.7)
19 (76.0)
31 (81.6)
Presence of Right Wrist
Pain
Yes
6 (26.1)
15 (62.5)
14 (56.0)
19 (50.0)
0.069
No
17 (73.9)
9 (37.5)
11 (44.0)
19 (50.0)
Presence of Left Wrist
Pain
Yes
2 (8.7)
8 (33.3)
10 (40.0)
13 (34.2)
0.085
No
21 (91.3)
16 (66.7)
15 (60.0)
25 (65.8)
Presence of Back Pain
Yes
18 (78.3)
22 (91.7)
16 (64.0)
32 (84.2)
0.089
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No
5 (21.7)
2 (8.3)
9 (36.0)
6 (15.8)
Presence of Low Back
Pain
Yes
13 (56.5)
20 (83.3)
20 (80.0)
30 (78.9)
0.123
No
10 (43.5)
4 (16.7)
5 (20.0)
8 (21.1)
Presence of Hip Pain
Yes
6 (26.1)
12 (50.0)
4 (16.0)
11 (28.9)
0.069
No
17 (73.9)
12 (50.0)
21 (84.0)
27 (71.1)
Presence of Right
Upper Leg Pain
Yes
5 (21.7)
8 (33.3)
2 (8.0)
4 (10.5)
0.061
No
18 (78.3)
16 (66.7)
23 (92.0)
34 (89.5)
Presence of Left Upper
Leg Pain
Yes
5 (21.7)
7 (29.2)
2 (8.0)
5 (13.2)
0.199
No
18 (78.3)
17 (70.8)
23 (92.0)
33 (86.8)
Presence of Right Knee
Pain
Yes
5 (21.7)
10 (41.7)
5 (20.0)
12 (31.6)
0.313
No
18 (78.3)
14 (58.3)
20 (80.0)
26 (68.4)
Presence of Left Knee
Pain
Yes
4 (17.4)
9 (37.5)
8 (32.0)
11 (28.9)
0.484
No
19 (82.6)
15 (62.5)
17 (68.0)
27 (71.1)
Presence of Right
Lower Leg Pain
Yes
2 (8.7)
7 (29.2)
4 (16.0)
5 (13.2)
0.246
No
21 (91.3)
17 (70.8)
21 (84.0)
33 (86.8)
Presence of Left Lower
Leg Pain
Yes
2 (8.7)
7 (29.2)
4 (16.0)
6 (15.8)
0.302
No
21 (91.3)
17 (70.8)
21 (84.0)
32 (84.2)
Presence of Right Foot
Pain
Yes
4 (17.4)
8 (33.3)
3 (12.0)
7 (18.4)
0.281
No
19 (82.6)
16 (66.7)
22 (88.0)
31 (81.6)
Presence of Left Foot
Pain
Yes
2 (8.7)
6 (25.0)
4 (16.0)
5 (13.2)
0.451
No
21 (91.3)
18 (75.0)
21 (84.0)
33 (86.8)
Physiotherapists working in different patient types; job satisfaction(p=0.011), neck region MSP
(p=0.002), right wrist region MSP (p=0.016), back region MSP (p=0.011), low back region MSP
(p=0.014), and right upper leg region statistically significant difference was found between MSP
(p=0.034) (Table 4). Finally, a low negative correlation was found between the job satisfactionof the
physiotherapists and the total MSP scores (r= -0.232, p=0.015). (Table 4). Finally, a low negative
correlation was found between the job satisfactionof the physiotherapists and the total MSP scores (r= -
0.232, p=0.015).
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Table 4. Comparison of qualitative data by type of patient received
According to the Patient Group Received
Orthopedic
Patient (n=23)
Neurological
Patient (n=24)
Pediatric
Patient (n=25)
Mixed Patient
(n=38)
X±SD
X±SD
X±SD
X±SD
p
Age (years)
26.52±3.87
27.25±3.74
26.20±3.20
25.34±1.58
0.256
BMI (kg/m2)
23.69±3.27
22.38±2.61
21.65±2.30
21.90±3.18
0.091
Average Number of
Patients Received per
Week
21.17±16.87
24.25±17.16
26.32±11.08
31.60±17.4
0.072
Job Experience (Year)
3.69±3.70
4.37±3.82
3.32±2.46
2.21±1.49
0.062
Number of Days
Worked per Week
5.26±0.54
4.95±0.62
4.88±0.66
5.15±0.63
0.082
Hours Worked Per
Day
8.13±0.75
7.87±0.89
8.00±0.28
7.97±0.71
0.855
Job Satisfaction
6.34±2.55
5.45±2.53
4.16±2.17
4.57±2.41
0.011*
Neck
3.10±3.74
12.27±13.88
2.66±4.08
8.96±10.44
0.002*
Right Shoulder
1.04±1.77
7.89±12.41
3.90±8.82
3.02±5.40
0.127
Left Shoulder
1.39±3.08
4.37±9.27
1.26±2.36
5.14±8.94
0.347
Right Upper Arm
0.34±0.97
3.93±8.52
0.74±1.54
1.07±2.21
0.075
Left Upper Arm
0.58±1.73
3.31±8.81
0.42±1.26
0.46±1.50
0.494
Right Wrist
0.45±0.83
13.00±26.81
3.78±8.21
8.47±19.76
0.016*
Left Wrist
0.86±3.12
3.18±8.88
1.28±2.03
3.14±7.66
0.145
Back
5.21±8.74
14.54±16.27
7.88±13.07
16.89±22.02
0.011*
Low back
3.06±4.41
15.08±17.29
7.88±17.95
15.89±25.06
0.014*
Hip
1.02±2.17
5.83±14.43
0.42±1.26
1.07±2.67
0.062
Right Upper Leg
0.95±2.17
5.00±12.92
0.12±0.41
0.21±0.68
0.034*
Left Upper Leg
1.36±3.36
4.83±12.79
0.12±0.41
0.30±0.86
0.106
Right Knee
0.67±1.52
6.02±10.77
0.86±2.83
1.39±3.56
0.148
Left Knee
2.41±6.26
5.52±13.07
1.04±2.82
0.81±1.55
0.487
Right Lower Leg
0.41±1.41
3.39±9.17
0.30±0.75
2.36±9.06
0.256
Left Lower Leg
0.67±2.92
3.27±8.79
0.42±1.26
2.44±9.05
0.291
Right Foot
0.26±058
5.45±13.57
0.24±0.70
1.32±6.47
0.166
Left Foot
0.28±1.07
3.25±8.82
0.74±2.80
1.30±6.49
0.399
Total
24.15±24.87
120.18±156.72
34.06±33.69
74.32±85.07
0.005
4. DISCUSSION
The aim of this study was to investigate musculoskeletal pain (MSP) in physiotherapists. The findings
of the study revealed that physiotherapists working with different patient types experienced pain in
various body parts, with a higher prevalence in the back, neck, and low back regions. Notably,
physiotherapists working with neurological patient groups reported significantly higher scores for neck
region pain compared to other groups. The study also highlighted that a majority of the participants did
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not find their working conditions to be ergonomic. This was attributed to factors such as fixed bed-chair
lengths, the challenging nature of patients they treated, and the lack of necessary equipment. Regarding
job satisfaction, the study found that physiotherapists working with orthopedic patient groups exhibited
higher levels of satisfaction, whereas those working with pediatric patient groups reported lower levels
of job satisfaction. It was also observed that physiotherapists working with pediatric patients were
predominantly employed in private institutions, while those working with orthopedic and mixed patient
groups were more commonly employed in public institutions.
The findings of the present study align with previous research conducted by Atli et al. (Atlı et al., 2020),
Arslan et al. (Arslan & Atıcı, 2019), and Akbaba et al. (Akbaba et al., 2018) regarding the prevalence
of musculoskeletal pain (MSP) in physiotherapists. According to these studies, physiotherapists
commonly experience pain in the back, low back, neck, lower back, hand, shoulder, knee, and foot
regions. The current study also reveals that physiotherapists working with neurological patient groups
experience higher rates of MSP. This can be attributed to the increased exertion of muscle power and
the need to support the body weight of multiple patients in this particular patient group. Additionally,
the absence of ergonomic beds and chairs in the institutions where they work contributes negatively to
the occurrence of MSP among these physiotherapists (Akbaba et al., 2018; Arslan & Atıcı, 2019; Atlı
et al., 2020). The consistency between the findings of the present study and the existing literature
strengthens the validity and reliability of the results.
The studies conducted by Adegoke et al. (Adegoke et al., 2008), Abaraogu et al. (Abaraogu et al., 2017),
Nordin et al. (Nordin et al., 2011), and Al-Eisa et al (Al-Eisa et al., 2012). on physiotherapists in various
countries consistently report that musculoskeletal pain (MSP) is commonly experienced in the lower
back and neck regions. Adegoke et al. (Adegoke et al., 2008) found that MSP was most prevalent in the
lumbar region among Nigerian physiotherapists. Similarly, Abaraogu et al. (Abaraogu et al., 2017)
reported that physiotherapists frequently experienced pain in the lower back and neck regions. Nordin
et al. (Nordin et al., 2011) observed that pain was most common in the lumbar region among Malaysian
physiotherapists. In a study by Al-Eisa et al. (Al-Eisa et al., 2012) conducted on physiotherapists from
Egypt and Saudi Arabia, it was also reported that the lower back and neck regions were the areas most
affected by pain. The consistency of these findings across different countries indicates that MSP is a
prevalent issue among physiotherapists worldwide. These studies provide valuable evidence supporting
the notion that MSP is a common concern in the physiotherapy profession.
The studies conducted by Salik and Özcan (Salik & Özcan, 2004), West and Gardner (West & Gardner,
2001), Cromie et al. (Cromie et al., 2000), Nordin et al. (Nordin et al., 2011), and Glover et al. (Glover
et al., 2005) consistently report a high prevalence of musculoskeletal pain (MSP) among
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Journal of Selcuk Health, Volume 4/Issue 2/2023
physiotherapists. Salik and Özcan (Salik & Özcan, 2004) found that 85% of physiotherapists
experienced MSP, while West and Gardner (West & Gardner, 2001) reported a prevalence of 55%.
Cromie et al. (Cromie et al., 2000) observed a high rate of 91% MSP among physiotherapists, and
Nordin et al. (Nordin et al., 2011) reported a prevalence of 71.6%. Glover et al. (Glover et al., 2005)
found that 68% of physiotherapists experienced MSP. These studies in the literature highlight several
common causes of MSP among physiotherapists, including excessive rotation and bending movements
in the lumbar region, difficulties in carrying and transferring dependent patients, prolonged periods of
working in the same position, repetitive tasks, and treating a high number of patients in a single day
(Cromie et al., 2000; Glover et al., 2005; Nordin et al., 2011; Salik & Özcan, 2004; West & Gardner,
2001). The findings of our study align with the literature, also reported a high prevalence of MSP among
physiotherapists, with a minimum rate of 80%. Additionally, a significant proportion of participants
(82%) stated that the working conditions were not ergonomic, with fixed bed-chair lengths, difficulties
in patient handling, and working in improper postures cited as reasons. These consistent findings
highlight the importance of addressing the ergonomic factors and workload management in the field of
physiotherapy to reduce the incidence of MSP and improve the well-being of physiotherapists.
The study conducted by Yakut et al. (Yakut & Yakut, 2011) supports our findings, indicating that
physiotherapists who work with orthopedic patients experience higher job satisfaction. This is in line
with the literature, as factors such as personal opportunities, working conditions, and financial gain are
known to influence job satisfaction (Sur et al., 2004).
It was reported in the study conducted by Yakut et al. in Physiotherapists who work with orthopedic
patient type that their job satisfactionis higher (Yakut & Yakut, 2011). Our results are consistent with
the literature. Factors such as personal opportunities, working conditions and financial gain are known
to affect job satisfaction (Sur et al., 2004). The presence of musculoskeletal pain (MSP) is another factor
that can impact job satisfaction. In the orthopedic patient group, physiotherapists may experience shorter
treatment durations, higher patient turnover, and potentially less MSP compared to other patient groups.
These factors may contribute to higher job satisfaction among physiotherapists working with orthopedic
patients. It is important to consider multiple factors when examining job satisfaction in physiotherapists,
as it can be influenced by various aspects of their work environment, patient population, and personal
experiences. By understanding these factors, interventions and improvements can be implemented to
enhance job satisfaction and overall well-being of physiotherapists.
The study our conducted indeed has some limitations that should be taken into consideration. The
collection of data online due to the pandemic may have limited the ability to directly interact with the
participants, potentially impacting the depth and quality of the data obtained. Additionally, the sample
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Journal of Selcuk Health, Volume 4/Issue 2/2023
of participants predominantly consisting of physiotherapists with less than 5 years of experience may
introduce a bias and limit the generalizability of the findings to the broader population of
physiotherapists. To address these limitations and further enhance the understanding of MSP and job
satisfaction among physiotherapists, future studies could be conducted in a face-to-face manner,
allowing for more detailed data collection and potentially reaching a wider range of physiotherapists
with varying levels of experience. It would also be beneficial to explore additional risk factors that can
influence job satisfaction, such as organizational factors, interpersonal relationships, workload, and
professional development opportunities. By addressing these limitations and expanding the scope of
investigation, future studies can provide a more comprehensive understanding of MSP and job
satisfaction among physiotherapists, leading to the development of targeted interventions and strategies
to improve their well-being and overall job satisfaction.
The presence of work-related MSP is quite high in physiotherapists. MSP is common especially in the
low back, back, neck, shoulder and wrist regions. Physiotherapists working in different patient groups
do not find the working conditions ergonomic. MSP negatively affects job satisfaction. While job
satisfactionis higher in physiotherapists working with orthopedic patient type, it is less in
physiotherapists working in pediatric patient group. Physiotherapists working with the neurological
patient group have MSP more in the neck region and right wrist region. Likewise, physiotherapists
working in neurological and mixed patient types have more MSP in the lower back and back region.
There are many factors that affect the job satisfaction of physiotherapists. It is thought that making the
working environment of physiotherapists ergonomic, arranging weekly and daily working hours,
optimizing the average number of patients and working in a balanced way from different patient types
will reduce MSP and increase job satisfactionin physiotherapists. There is a need for cohort studies
examining how and when musculoskeletal pain occurs in future studies.
Supporting Institution
“None”.
Conflict of Interest
“The authors have no conflicts of interest to declare”.
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