Global prevalence of musculoskeletal disorders among physiotherapists: a systematic review and meta-analysis

Abstract

Background: Musculoskeletal disorders (MSD) are one of the most important problems among physiotherapists worldwide. However, there is no meta-analysis of the MSD prevalence in all body areas among physiotherapists.

Objectives: The purpose was to investigate and estimate the worldwide prevalence of MSD among physiotherapists using a systematic review-, meta-analysis and meta-regression.

Methods: The systematic review, meta-analysis and meta-regression were performed in 2022 using the PRISMA guidelines.

Data sources: The search was performed on PubMed/Medline, ScienceDirect, Google Scholar, Medeley and Science.gov databases.

Study appraisal: The quality appraisal of the included articles was assessed using the critical appraisal tool for cross-sectional studies AXIS.

Results: A total of 722 articles were found. After screening and comparison with the inclusion criteria, 26 studies were retained. Based on the random-effects model, the worldwide MSD prevalence in neck, upper back, mid back, lower back, shoulders, elbows, wrists/hands, thumb, hips/thighs, knees/legs, and ankles/feet was 26.4% (CI 95%: 21.0-31.9%), 17.7% (CI 95%: 13.2-22.2%), 14.9% (CI 95%: 7.7-22.1%), 40.1% (CI 95%: 32.2-48.0%), 20.8% (CI 95%: 16.5-25.1), 7.0% (CI 95%: 5.2-8.9), 18.1% (CI 95%: 14.7-21.5%), 35.4% (CI 95%: 23.0-47.8), 7.0% (CI 95%: 5.2-8.8), 13.0% (CI 95%: 10.3-15.8), and 5% (CI 95%: 4.0-6.9) respectively. The neck and shoulder prevalence of four continents were close to the world prevalence. No effect of continent was found on MSD prevalence. The heterogeneity of the results obtained in the meta-analysis and meta-regression was discussed.

Conclusions: Based on the random effects model, the results of the worldwide meta-analysis showed that lower back pain, thumb, neck and shoulder were the area most at risk for MSD and were therefore those to be monitored as a priority. Recommendations were proposed for future reviews and meta-analyses.

Keywords: Body area; Meta-analysis; Meta-regression; Musculoskeletal disorders; Physiotherapists; Prevalence; Systematic review.

Fig. 1

PRISMA Flow Chart

Fig. 2

Prevalence of musculoskeletal disorders in neck amongst studies included

Fig. 3

Prevalence of musculoskeletal disorders in upper back amongst studies included

Fig. 4

Prevalence of musculoskeletal disorders in mid back amongst studies included

Fig. 5

Prevalence of musculoskeletal disorders in lower back amongst studies included

Fig. 6

Prevalence of musculoskeletal disorders in shoulder amongst studies included

Fig. 7

Prevalence of musculoskeletal disorders in elbow/forearm amongst studies included

Fig. 8

Prevalence of musculoskeletal disorders in wrist/hand amongst studies included

Fig. 9

Prevalence of musculoskeletal disorders in thumb amongst studies included

Fig. 10

Prevalence of musculoskeletal disorders in hip/thigh amongst studies included

Fig. 11

Prevalence of musculoskeletal disorders in knee/leg amongst studies included

Fig. 12

Prevalence of musculoskeletal disorders in ankle/foot amongst studies included

Fig. 13

Meta-regression to evaluate the trends in the prevalence of neck, lower back and shoulder musculoskeletal disorders in relation to year of publication, age of participants and Gross Domestic Product (GDP)