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Aptidão física relacionada com a saúde, problemas músculo-esqueléticos e capacidade para o trabalho dos fisioterapeutas
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Introdução: A fisioterapia é uma profissão fisicamente exigente que requer um elevado nível de aptidão física para realizar as atividades inerentes à função e cuja prevalência de problemas músculo-esqueléticos é elevada. Os problemas músculo-esqueléticos têm implicações em termos de capacidade para o trabalho, produtividade e de aumento de custos associados. Objetivos: Caracterizar os fisioterapeutas em termos de aptidão física relacionada com a saúde (AFRS), de prevalência de problemas músculo-esqueléticos (PME) e de capacidade para o trabalho (CT); perceber a relação entre os níveis de AFRS nos diversos componentes, os PME e os níveis de CT; perceber se níveis anteriores de AFRS estavam associados ao aparecimento de novos PME e a alteração da CT. Materiais e métodos: Foi realizado um estudo longitudinal com dois momentos separados por 12 semanas. A amostra foi constituída por 98 fisioterapeutas a trabalhar na região centro do país. Em T0, foram avaliados os componentes de AFRS através de testes validados, os PME através do Questionário Nórdico Músculo-Esquelético (QNME) e a CT através do Índice de Capacidade para o Trabalho (ICT). Em T1, os PME e a CT foram reavaliados. Resultados: Em média, os fisioterapeutas apresentaram um nível de aptidão física muito mau na composição corporal, razoável a superior de aptidão cardiorrespiratória, fraco de força muscular, a necessitar de melhoria na resistência muscular na força de braços, muito abaixo da média na resistência muscular em força abdominal e razoável a muito bom de flexibilidade. Apresentaram uma elevada prevalência de PME sendo a cervical (67,5%), a lombar (59,2%), os ombros (53,1%) e os punhos/mãos (45,9%) as zonas mais afetadas e uma CT entre o bom e o excelente. Os que tinham PME nos cotovelos tinham pior composição corporal assim como os que apresentavam limitação por PME na lombar e ancas/coxas. Os que tinham PME nos joelhos tinham melhor composição corporal. Os que tinham PME na cervical e nos punhos/mãos tinham pior resistência cardiorrespiratória. Os que tinham PME nos punhos/mãos tinham melhor força muscular e os que tinham PME na lombar tinham melhor resistência muscular de força de braços. Os que tinham limitação por PME na cervical tinham melhor flexibilidade. Encontrou-se correlação positiva moderada entre a composição corporal e a intensidade da dor na cervical, ombros e lombar, e entre a flexibilidade e a intensidade da dor nos joelhos e correlação negativa moderada entre flexibilidade e a intensidade da dor cervical e a resistência muscular de força abdominal e a intensidade da dor torácica. Os que apresentavam PME em várias regiões tinham pior CT e encontrou-se correlação negativa moderada entre a intensidade da dor na cervical e a CT. Em T1, os que deixaram de sentir limitação por PME na cervical tinham uma melhor flexibilidade e os que deixaram de ter PME nos cotovelos tinham melhores níveis de composição corporal. Conclusão: Os fisioterapeutas apresentaram uma AFRS que variou do muito mau ao superior dependendo dos componentes, uma elevada prevalência de PME e uma CT entre o bom e o excelente. A prevalência de PME, a limitação nas atividades e a intensidade da dor estavam associadas a uma pior composição corporal (quando presentes na cervical, ombros, cotovelos, lombar e ancas/coxas), a uma pior resistência cardiorrespiratória (quando presentes na cervical e punhos/mãos) e a uma pior flexibilidade (quando presentes nos joelhos), enquanto que a prevalência de PME, a limitação nas atividades e a intensidade da dor estavam associadas a melhor composição corporal (quando presentes nos joelhos), a melhor força muscular (quando presentes nos punhos/mãos), a melhor resistência muscular (quando presentes na torácica e lombar) e a melhor flexibilidade (quando presentes na cervical). A prevalência de PME e intensidade da dor estavam associadas a uma pior CT. Os que deixaram de ter limitação por problema na cervical tinham uma melhor flexibilidade e os que deixaram de ter PME nos cotovelos tinham melhor composição corporal.
Introduction: Physiotherapy is a physically demanding profession that requires a high level of physical fitness to perform their inherent function and activities with a high prevalence of musculoskeletal disorders. Musculoskeletal disorders have implications in terms of work ability, productivity and imply costs. Objectives: Characterize the physiotherapists in terms of health-related physical fitness, prevalence of musculoskeletal disorders and work ability; understand the relation between levels of the components of health-related physical fitness, the musculoskeletal disorders and work ability; understand if previous levels of health-related physical fitness were associated with the emergence of new musculoskeletal disorders and change in work ability. Methods: A longitudinal study was performed in two phases separated by 12 weeks. The sample consisted of 98 physiotherapists working in the central region of Portugal. At the first moment, the study evaluated the components of health-related physical fitness through validated tests, musculoskeletal disorders by applying the Nordic Musculoskeletal Questionnaire and the work ability through the Work ability Index. In the second phase, musculoskeletal injuries and work ability were reassessed. Results: On average, physiotherapists had a very poor level of physical fitness related to body composition, a reasonable to higher level of cardiorespiratory fitness, a weak muscular strength, in need of improvement in muscular endurance of arms muscles, well below average in muscular endurance of abdominal muscles and reasonable to very good flexibility. They had a high prevalence of musculoskeletal disorders with the neck (67.5%), low back (59.2%), shoulders (53.1%) and the wrists/hands (45 9%) as the most affected areas and a good to excellent work ability. Those with musculoskeletal disorders in the elbows had worse body composition as well as those with limitation caused by disorders in the low back and hips/thighs. Those with musculoskeletal disorders in the knees had better body composition. Those with problems in the neck and wrists/hands had worse cardiorespiratory fitness. Those with problems in the wrists/hands had better muscle strength and those with problems in the low back had better muscular endurance of arms muscles. Those with limitations caused by disorders in the neck had better flexibility. A moderate positive correlation was found between the body composition and the intensity of pain in the neck, shoulders and low back, and between the flexibility and the intensity of pain in the knees and a moderate negative correlation was found between flexibility and neck pain intensity and muscular endurance of abdominal muscles and intensity of pain in the thoracic region. Those with musculoskeletal disorders in various regions had worst work ability and it was found a moderate negative correlation between the intensity of pain in the neck and work ability. In the second phase of the study, those who no longer feel limited by problems in the neck had a better flexibility and those who no longer have problems had a better body composition. Conclusion: Physiotherapists had a health-related physical fitness that goes from very poor to superior depending on the components, a high prevalence of musculoskeletal injuries and good to excellent work ability. The presence of problems, limitations in activities and pain intensity were associated with a worse body composition (when in the neck, shoulders, elbows, low back and hips/thighs), a worse cardiorespiratory endurance (when in the neck and wrists/hands) and a worse flexibility (when in the knees) while the prevalence of problems, limitations in activities and pain intensity were associated with better body composition (when in the knees), better muscular strength (when in the hand/wrist), and better muscular endurance (when in thoracic and low back) and the best flexibility (when in the neck). The prevalence of musculoskeletal disorder and pain intensity were associated with a worse work ability. Those who no longer have limitation caused by neck problem in the second phase had better flexibility and those who no longer have problems had a better body composition
Introduction: Physiotherapy is a physically demanding profession that requires a high level of physical fitness to perform their inherent function and activities with a high prevalence of musculoskeletal disorders. Musculoskeletal disorders have implications in terms of work ability, productivity and imply costs. Objectives: Characterize the physiotherapists in terms of health-related physical fitness, prevalence of musculoskeletal disorders and work ability; understand the relation between levels of the components of health-related physical fitness, the musculoskeletal disorders and work ability; understand if previous levels of health-related physical fitness were associated with the emergence of new musculoskeletal disorders and change in work ability. Methods: A longitudinal study was performed in two phases separated by 12 weeks. The sample consisted of 98 physiotherapists working in the central region of Portugal. At the first moment, the study evaluated the components of health-related physical fitness through validated tests, musculoskeletal disorders by applying the Nordic Musculoskeletal Questionnaire and the work ability through the Work ability Index. In the second phase, musculoskeletal injuries and work ability were reassessed. Results: On average, physiotherapists had a very poor level of physical fitness related to body composition, a reasonable to higher level of cardiorespiratory fitness, a weak muscular strength, in need of improvement in muscular endurance of arms muscles, well below average in muscular endurance of abdominal muscles and reasonable to very good flexibility. They had a high prevalence of musculoskeletal disorders with the neck (67.5%), low back (59.2%), shoulders (53.1%) and the wrists/hands (45 9%) as the most affected areas and a good to excellent work ability. Those with musculoskeletal disorders in the elbows had worse body composition as well as those with limitation caused by disorders in the low back and hips/thighs. Those with musculoskeletal disorders in the knees had better body composition. Those with problems in the neck and wrists/hands had worse cardiorespiratory fitness. Those with problems in the wrists/hands had better muscle strength and those with problems in the low back had better muscular endurance of arms muscles. Those with limitations caused by disorders in the neck had better flexibility. A moderate positive correlation was found between the body composition and the intensity of pain in the neck, shoulders and low back, and between the flexibility and the intensity of pain in the knees and a moderate negative correlation was found between flexibility and neck pain intensity and muscular endurance of abdominal muscles and intensity of pain in the thoracic region. Those with musculoskeletal disorders in various regions had worst work ability and it was found a moderate negative correlation between the intensity of pain in the neck and work ability. In the second phase of the study, those who no longer feel limited by problems in the neck had a better flexibility and those who no longer have problems had a better body composition. Conclusion: Physiotherapists had a health-related physical fitness that goes from very poor to superior depending on the components, a high prevalence of musculoskeletal injuries and good to excellent work ability. The presence of problems, limitations in activities and pain intensity were associated with a worse body composition (when in the neck, shoulders, elbows, low back and hips/thighs), a worse cardiorespiratory endurance (when in the neck and wrists/hands) and a worse flexibility (when in the knees) while the prevalence of problems, limitations in activities and pain intensity were associated with better body composition (when in the knees), better muscular strength (when in the hand/wrist), and better muscular endurance (when in thoracic and low back) and the best flexibility (when in the neck). The prevalence of musculoskeletal disorder and pain intensity were associated with a worse work ability. Those who no longer have limitation caused by neck problem in the second phase had better flexibility and those who no longer have problems had a better body composition
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Keywords
Aptidão física relacionada com a saúde Sistema Musculoesquelético - fisiopatologia Fisioterapeutas Avaliação da Capacidade de Trabalho