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Title: Upper extremity work-related musculoskeletal injuries among chiropractic students at the Durban University of Technology
Authors: Singh, Kyle Andrew 
Keywords: Musculoskeletal injuries;Chiropractic students;Durban University of Technology
Issue Date: 27-May-2021
Background: Chiropractic students the world over undergo rigorous training in
manual therapy, specifically musculoskeletal manipulation and adjustment.
These therapeutic modalities involve the use of the upper extremity to deliver its
effects, usually with high velocity and force. This leaves the upper extremity
vulnerable to injury, as a result of the repetitive and forceful nature of these
manual techniques. Despite this risk, the research available on work-related
musculoskeletal injuries of chiropractic students in South Africa is limited. This
study aims to determine the prevalence of upper extremity work-related
musculoskeletal injuries among chiropractic students at the Durban University
of Technology, and selected risk factors associated with work-related
musculoskeletal injuries.
Method: The study design was a quantitative, descriptive, self-administered
questionnaire study that used the total available population. The questionnaire
was adapted from a similar study and included the use of a pilot study. The
questionnaire had three sections: the first for demographic data, the second
was applicable for any new injury to the upper extremity from work-related
tasks, and the third was applicable for any old injuries to the upper extremity
that were aggravated by work-related tasks. Prevalence was estimated using
95% confidence intervals. Factors associated with injury were assessed at
univariate level, using Pearson’s chi-square tests and t-tests, and factors
associated at the <0.1 level were selected as independent variables in a
multiple logistic regression model to predict risk of injury. The odds ratios and
95% confidence intervals were reported. A stepwise backward selection
method, based on likelihood ratios, was used to arrive at a final model
consisting only of statistically significant risk factors (p<0.05). Chi-square testing
and cross-tabulations were performed on the use of dominant hand and injury.
Results: Eighty-six chiropractic students (n=86) were eligible for the study,
seventy-seven elected to participate in the study, giving a response rate of
93.9%. The period prevalence of upper extremity work-related musculoskeletal
injuries was 59.7% (95% CI 47.93 to 70.57%). The most commonly injured areas were the wrist (60%), shoulder (20%) and hand (17%), with majority of
the injuries involving the soft tissue structures: muscle/ tendon strain (42%),
ligament sprain (17%) and tendinitis (17%). Most injuries occurred during
adjustive procedures (74%) and ischemic compression (19%).
None of the demographic variables showed a significant association with
prevalence of injury, apart from a moderately non-significant association with
year of study (p=0.080). The frequent use of electro-modalities (p=0.073) and
temperature therapy (p=0.077) were suggestive of possible associations,
however, were not statistically significant. The results showed no
significant differences between frequency of adjustments and injury. Despite an
absence of statistical significance, a trend was noted showing an increased
likelihood of injury when adjusting with the dominant hand.
Conclusion: The study findings are consistent with those of similar
international and local studies on the chiropractic profession (both academic
training and professional), determining a high prevalence of work-related
musculoskeletal injuries. The wrist was most commonly injured when
performing adjustive procedures with the dominant hand. This study is in
response to a call for further investigation and will help in future efforts to
develop an injury preventative strategy for chiropractic training institutions.
A dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology in the Department of Chiropractic and Somatology at the Durban University of Technology, 2021.
Appears in Collections:Theses and dissertations (Health Sciences)

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