The prevalence of thumb problems in Australian physiotherapists is high: an observational study.

QUESTION: What is the lifetime and current prevalence of thumb problems in Australian physiotherapists and what are the factors associated with thumb problems? DESIGN: Survey of a random cross-section of physiotherapists. PARTICIPANTS: 1562(approximately 10% of the total) registered Australian physiotherapists. OUTCOME MEASURES: General questions covered demographic information, area of practice, hours worked per week, and years worked as a physiotherapist. Specific questions about thumb problems covered thumb affected, symptoms, onset of symptoms, treatment sought, relevance of work-related factors, and joint hypermobility. RESULTS: 1102 (71%) questionnaires were returned and 961 (68%) completed. The lifetime prevalence of thumb problems was 65% and the current prevalence was 41%. Factors that were significantly associated with thumb problems included: working in orthopaedic outpatients (OR 3.2, 95% CI 1.8 to 5.8); using manual therapy (OR 2.3 to 3.4, 95% CI 1.7 to 5.1), trigger point therapy (OR 2.3, 95% CI 1.7 to 3.0) and massage (OR 2.1, 95% CI 1.6 to 2.8); having thumb joint hypermobility (OR 2.2 to 2.6, 95% CI 1.4 to 4.5); or an inability to stabilise the joints of the thumb whilst performing physiotherapy techniques (OR 4.2, 95% CI 2.9 to 5.9). Of those respondents who reported thumb problems, 19% had changed their area of practice and 4% had left the profession as a result of their thumb problems. CONCLUSION: The prevalence of thumb problems in Australian physiotherapists appears to be high and can be of sufficient severity to impact on careers.

An overview of the Australian Physiotherapy Association accredited practice data collection.

The Accreditation Committee of the Australian Physiotherapy Association (APA) undertook a national survey of accredited private practices from September to November 1995. It aimed to describe patient and episodes of care characteristics, and provide accredited practices with large scale quality improvement opportunities. Of the private practices accredited in August 1995, 40.6 per cent (122) participated. Data were generated on 12,403 rooms-based patients. Practice-specific information on patient and episode characteristics was sent to each participant, allowing individual comparison with the group data. Lessons were learnt, not only in the administration of multi-centre studies, but also in the focus of future studies. This study highlighted the need to develop standard diagnosis coding and robust outcome measurements for use in private physiotherapy practice.

The association between cervical excursion angles and cervical short flexor muscle endurance.

This study employed a randomly selected sample of 427 never-injured subjects to examine the relationship between poor posture and deep cervical short flexor muscle endurance. Poor posture was described as extreme angular excursion of both the upper and lower aspects of the cervical spine. For both men and women, poor deep cervical short flexor muscle endurance was associated only with extremely large excursion angles traced by the upper cervical spine, that is, head posture associated with excessive cervical lordosis rather than a forward translated head position. Further research is needed to clearly define poor cervical posture, and to investigate the specific relationship of deep short cervical flexor endurance with head on neck posture, in order that postural correction is specific to the underlying biomechanics.