PREVALENCE, RISK FACTORS AND IMPACT OF

WORK RELATED MUSCULOSKELETAL

DISORDERS AMONG PHYSICAL THERAPISTS
WORKING IN SELECTED PRIVATE AND
GOVERNMENT HOSPITALS IN PAMPANGA
Dungca, Vince Marc M1; Hernandez, Emil G1; Nucup, Ric Samuel1; Salugao, Angelo 1.
Vince Marc M. Dungca, Emil G. Hernandez, Ric Samuel Nucup, Angelo Salugao
1
vincemarcd@yahoo.com, Emilhernandez0101@gmail.com, ricsam720@icloud.com,
angelosalugao@yahoo.com,

Academic Editor; name

Received date:
Accepted; date:
Published date:

ABSTRACT
Keywords: Physical Therapy, Work-Related Musculoskeletal Disorder

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 I. Introduction
WRMDs or Work-related musculoskeletal disorders are diseases related and/or
aggravated by work that can affect the upper limb, the lower back area and the lower limbs.
WRMDs can be defined by impairments of bodily structures such as muscles, joints,
tendons, ligaments, nerves, bones and the localized blood circulation system, caused or
aggravated primarily by work itself or by the work environment [1]. It is the largest and
most expensive source of injuries on work-related musculoskeletal disorders. Work-related
musculoskeletal disorders are responsible for morbidity in many working populations and
are known as an important occupational problem with increasing compensation and health
costs, reduced productivity, and lower quality of life [2].

A study entitled “Discourse on the Diseases of Workers” indicated that workers could
be harmed by either “the harmful character of the materials that they handle” or “certain
violent and irregular motions and unnatural postures of the body, by reason of which the
natural structure of the vital machine is so impaired that serious diseases gradually develop
therefrom.” The author consistently emphasized the link between occupation and health,
earning him the title “father of occupational medicine. Cumulative trauma disorder,
repetitive motion disorder, and repetitive strain injury are among the terms used to refer to
the work-related musculoskeletal disorders associated with occupational illness [3].

Work-related musculoskeletal disorder is one of the most general causes of chronic

pain and physical disorders occurring among modern workers. WMSD results in loss of
work time, restriction of tasks, or transfer to a different job, thereby affecting the quality
of life of the patient [4-7].

The World Health Organization recognizes the impact of work related musculoskeletal
diseases due to the consequences of acquiring injuries in the workplace. The two
classifications of injuries are acute and chronic. Acute injuries are due to short term sudden
heavy load causing failure in the structures and function of muscle and bones due to a
heavy lift. Whereas chronic is due to long term repetitive loading that may be disregarded
and ignored by workers. Repetitive strains, repetitive motion injuries, and cumulative
trauma are few examples of chronic injuries. Therefore WHO characterized WMSD as

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multifactorial, indicating that a number of risk factors such as high intensity forces, long
exposure duration, highly repetitive exertions, strong postural demands, disadvantageous
environment or psychosocial conditions can contribute and exacerbate these maladies. The
presence of these risk factors increases the occurrence of these injuries, thus making
WMSD an international health concern because it can lead to disability and decreased
productivity [8].

Previous research reported that the occurrence of WRMDs was related to high
biomechanical loading caused by inappropriate handling [9-10]. Silverstein et al.[11]
observed that occupational risk factors such as repetitive movement, tasks of high intensity,
and uncomfortable postures were associated with musculoskeletal disorders. Studies of
industrial health workers report that physical therapists have a high prevalence of WRMD
[12-14]. The factors affecting this high WRMD prevalence include repetitive movements,
continuous bending, lifting and transferring dependent patients, unexpected abrupt
movements of the patient, manual therapy, limited working space, lack of personnel, age,
and gender [15-16]. These types of injuries are common among physiotherapists [12, 13,
15, 17 19].

There is evidence that work-related musculoskeletal disorders (WRMDs) have a

significant impact on physical therapists. In prior studies, [11, 13-16] physical therapists
reported taking sick time, changing practice habits, changing work settings, or leaving the
profession due to WMSDs. A previous study reported that 1 in 6 physical therapists
changed settings or left the profession due to WMSDs. A previous study also reported that
32% of physical therapists with WMSDs lost work time.

WMSD in physical therapists is associated with the therapist’s age and clinical
experience. Most previous studies have reported that therapists experience symptoms
before they reach 30 years of age, and the incidence rate within five years of graduation is
high[7, 11, 16, 18, 20]

A previous study noted that WRMD areas varied in physical therapists: low back
(48%), neck (33%), upper back (23%), and thumb injuries (23%). The reason for the high

3
prevalence of low back injury is that therapists who take care of patients have to repeat
motions such as lifting and transferring, standing for a long time, and frequent twisting and
bending [16].

The suggested reason is that new physical therapists lack professional experience,
knowledge, and techniques, and that they are rotationally dispatched to different places,
thereby running a higher risk of injury [21-22].

Physical therapists are no exception from having WMSD. The researchers would like
to promote awareness and early prevention of WMSD. The objective of this study is to
determine the prevalence of WMSDs from the past months among physical therapy
professionals working in private and government hospitals in Pampanga, to find out the
possible risk factors that may contribute to acquire WMSDs and to determine the impact
of WMSD on physical therapist’s work performance.

II. Materials and Methods

Research Study Design

This descriptive type of cross sectional study was carried out with the aim to
determine the prevalence, risk factors and impact of WMSDs among physical therapists
working in private and government hospitals in Pampanga. A cross sectional research
method was used because the subjects differ in some variables but have one characteristic
in common as being registered Physical Therapists. Data will be collected at the same time
from registered physical therapists but different in a key factor of interest such as age,
income levels, or geographic location.

Participants, Sampling Design and Sample Size

Included in the study are physical therapist working in both private and government
hospitals in Pampanga namely; Angeles University Foundation Medical Center (10),
Angeles Medical Center Inc. (6), Sacred Heart Medical Center (7), PRI Medical Center
(4), Medical City Clark (8), Our Lady of Mt. Carmel Clark (1), Our Lady of Mt. Carmel

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Hospital (6), Jose B. Lingad Memorial Center (17), St. Raphael Foundation (2), Mother
Teresa of Calcutta (5) and Rafael Lazatin Memorial Center (3).
The sampling technique that will be used is stratified randomized technique, this
technique will divide the population into small groups/strata to make the study feasible.
Every group of physical therapists that will be present on the day of survey will be
classified as one strata for that respective hospital. Approximately 70 participants will be
included in the study and those who are on duty at the time of the visit will be part of the
survey. 70 participants as estimated were determined by visiting the hospitals ahead of time
before the study was conducted

Research Instrument
The researchers will use the standardized Nordic Musculoskeletal Questionnaire.
The Nordic Musculoskeletal Questionnaire (NMQ) was developed from a project funded
by the Nordic Council of Ministers [23]. The aim was to develop and test a standardized
questionnaire methodology allowing comparison of low back, neck, shoulder and general
complaints for use in epidemiological studies. A general questionnaire of 40 forced-choice
items identifying areas of the body causing musculoskeletal problems. Completion is aided
by a body map to indicate nine symptom sites being neck, shoulders, upper back, elbows,
low back, wrist/hands, hips/thighs, knees and ankles/feet. Respondents are asked if they
have had any musculoskeletal trouble in the last 12 months and last 7 days which has
prevented normal activity. Aside from the Nordic Musculoskeletal Questionnaire,
demographic profile of the respondents such as the respondent’s age, sex, height, weight,
duty hours, number of patients per day, type of hospital affiliation, duty hours per day and
work experience in current hospital will also be asked to determine if these are contributing
factors in acquiring WRMDs. Lastly, a questionnaire from the study entitled “Work-related
musculoskeletal disorders: A survey of physical therapists in Izmir-Turkey” will also be
used to determine the risk factors that may contribute to acquire WMSDs and the impact
of WMSDs on physical therapists work performance. The instrument will be asking the
possible risk factors that have caused the respondent to have musculoskeletal pain and the
instrument will also be asking the respondents if the WRMDs caused him to alter his work

5
performance. There are set of activities that the respondent will check to determine all of
the possible affected aspect.

Inclusion and Exclusion Criteria

The following inclusion criteria are: registered physical therapists with willingness
to take part in the study, full time registered physical therapist with at least 12 months of
work experience working in a government or private hospital in Pampanga with or without
pre-existing musculoskeletal disorder related to work. The following exclusion criteria are:
with current non physical therapy related musculoskeletal disorder that may be hereditary
in nature and physical therapist employees on leave.

Withdrawal Criteria
Participating in this research study is completely voluntary. Participants have an
option to refuse in participating and withdraw from the study anytime without any
obligations.

Research Procedure
A letter of intent (see Appendix A) will be given to each chief physical therapist of
different hospitals in Pampanga prior to data collection to ask for approval to conduct the
study and to identify the total number of allied health workers. An informed consent (see
Appendix B) will also be given to each respondent to ask if they are willing to participate
in the study.
The researchers will be utilizing a standardized questionnaire (Appendix C) to
achieve the objective of the study and the questionnaires will be distributed to the
participants personally by the researchers. The respondents will be asked to answer the
questionnaire guided by the researchers during their vacant hours for 20 minutes and will
be collected right after answering.
The data will be stored in the researcher’s password protected files in the personal
laptops or computers. Once all the data gathered, tabulated and undergone a statistical
treatment for interpretation and analysis of results, all answered survey questionnaire will
undergo standard process of disposal to prevent unauthorized access to/use of the data. The

6
results of the study will be stored in the AUF library after the study has been completed
and will be available for all students.

Ethical Considerations
There are no direct benefits involved in participating in the study. However, identifying
the WRMDs will be helpful in preventing its occurrence and modification of
activities/posture will be useful in making Physical Therapist free from WRMDs. In this
study, the participants will not be involved in any risk. Although, there are some questions
that the participants may be required to share some personal information
We will make sure that participants’ identity will remain confidential. Participants’
personal information provided such as contact number and/or e-mail address will be kept
in private and will be subjected with utmost confidentiality. All other pertinent information
that the participants’ have provided including answers to questions in the survey will be
kept private and will be used solely for the objective of the study. Actual survey forms and
master list will be kept for 1 year after the completion of the study and will be properly
discarded thereafter.
This study will undergo ethics review and for the approval of the AUF Ethics Review
Committee Board.

Statistical Analysis
Table 1. Demographic profile of respondents

Characteristic Criteria Frequency Percentage

Age 20 – 30 39 78.00 %
31 – 40 6 12.00 %
41 – 50 5 10.00 %
Gender Male 27 54.00 %
Female 23 46.00 %
Type of Hospital Private 34 68.00 %
Affiliation Government 16 34.00 %
BMI Underweight 2 4.00 %
Normal 30 60.00 %
Overweight 15 30.00 %
Obese 3 6.00 %
Duty Hours/Day Less than 8 2 4.00 %
8 Hours or More 48 96.00 %

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 Number of Patients Less than 5 4 8.00 %
5 – 10 42 84.00 %
More than 10 4 8.00 %
Work Experience 1–5 44 88.00 %
6 – 10 2 4.00 %
11 – 15 4 8.00 %

Table 2. Distribution of the physical therapists with WRMDs according to age,

gender, type of hospital affiliation, BMI, duty hours per day, number of patients per
day and work experience in current hospital (Prevalence).

Characteristic Criteria Total number Number of Percentage

of PTs PTs with
WRMDs
Age 20 – 30 39 39 100%
31 – 40 6 6 100%
41 – 50 5 5 100%
Gender Male 27 27 100%
Female 23 23 100%
Type of Hospital Private 34 34 100%
Affiliation Government 16 16 100%
BMI Underweight 2 2 100%
Normal 30 30 100%
Overweight 15 15 100%
Obese 3 3 100%
Duty Hours/Day Less than 8 2 2 100%
8 Hours or More 48 48 100%
Number of Less than 5 4 4 100%
Patients 5 – 10 42 42 100%
More than 10 4 4 100%
Work Experience 1–5 44 44 100%
6 – 10 2 2 100%
11 – 15 4 4 100%

Table 3. Risk Factors

Risk Factors Frequency Percentage

Lifting heavy equipment or
42 84.00 %
patients
Bending/Twisting 31 62.00 %
Transferring a Patient 31 64.00 %
Performing Repetitive Tasks 27 54.00 %
Maintaining a Position for a
26 52.00 %
Prolonged Period of Time

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Working in an Awkward or
24 48.00 %
Cramped Position
Performing Manual Therapy
22 44.00 %
Techniques
Responding to an
Unanticipated or Sudden 22 44.00 %
Movement by a Patient
Working When Physically
20 40.00 %
Fatigued
Applying Modalities 17 34.00 %
Slipping/Tripping/Falling 6 12.00 %

Table 4. The frequencies of WRMDs at body part affected

Prevented from
Presence of carrying out Consulted a Trouble in the
Body Area
pain during the normal activities physician for area during the
Affected
last 12 months during the last this condition last 7 days
12 months
Neck 30 60.00 % 3 6.00 % 1 2.00 % 15 30.00 %
Shoulders 19 38.00 % 5 10.00 % 3 6.00 % 5 10.00 %
Upper Back 33 66.00 % 5 10.00 % 3 6.00 % 21 42.00 %
Elbows 7 14.00 % 2 4.00 % 0 0.00 % 2 4.00 %
Wrists/Hands 21 42.00 % 7 14.00 % 0 0.00 % 10 20.00 %
Lower Back 44 88.00 % 11 22.00 % 4 8.00 % 23 46.00 %
Hips/Thighs 10 20.00 % 4 8.00 % 1 2.00 % 4 8.00 %
Knees 19 38.00 % 3 6.00 % 1 2.00 % 7 14.00 %
Ankles/Feet 20 40.00 % 3 6.00 % 1 2.00 % 7 14.00 %

Table 5. Impact of WRMDs on physical therapist’s work performance

Possible Impact Frequency Percentage

Use Improved Body
46 92.00 %
Mechanics
Change Working Position
31 62.00 %
Frequently
Take More Rest Breaks or
27 54.00 %
Pauses during the Workday
Avoid Lifting 21 42.00 %
Stop Working When Hurt or
13 26.00 %
When Symptoms Occur
Increase Use of Other
12 24.00 %
Personnel

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 Encourage Patient
Responsibility for Carrying 11 22.00 %
Out Treatment
Decrease Manual
9 18.00 %
Techniques
Increase Use of Mechanical
9 18.00 %
Aids
Change Work Schedule
(Overtime, Irregular shifts, 6 12.00 %
Length of Workday)
Increase Administrative
Time; Decrease Patient Care 0 0.00 %
Time

III. RESULTS
The 50 respondents included 23 females (46%) and 27 males (54%) aging from 20-50
years (range, 20-30 years are 39 respondents [78%]) (range, 31-40 years are 6 respondents
[12%]) (range, 41-50 years are 5 respondents [10%]). In relation to type of hospital
affiliation, 34 of the respondents work in a private hospital (68%) and 16 work in a
government hospital (34%). While for the duty hours of the respondents, 2 of the physical
therapists work for <8 hours per day (4%) and 58 work for 8 hours or more (96%). For the
BMI classification of the physical therapists, 30 of the respondents are classified as normal
(60%), 15 are overweight (30%), 3 are obese (6%) and 2 are underweight (4%), As
answered in the questionnaire, 42 of the respondents are handling 5-10 patients per day
(84%), 4 are handling more than 5 (8%) and 4 are handling less than 5 (8%). Lastly,
according to working years in current hospital 44 of the respondents already have 1-5 years
(88%), 4 have 11-15 years (8%) and 2 have 6-10 years (4%).
In table 2, it shows that WRMDs among physical therapists in Pampanga is highly
prevalent and the demographic profile of the respondents cannot be concluded as a
contributing factor since all of the respondents (100%) answered that they have acquired
WRMDs for the last 12 months regardless of age, gender, type of hospital affiliation, BMI,
duty hours per day, number of patients per day and work experience in current hospital.
The respondents who had experienced a WRMD indicated that lifting (84%) was the
most contributing factor to acquire WRMD followed by bending/twisting (62%),

10
transferring a patient (62%), performing repetitive tasks (54%), maintaining a position for
a prolonged period of time (52%), working in an awkward or cramped position (48%),
performing manual therapy techniques (44%), responding to an unanticipated or sudden
movement by a patient (44%), working when physically fatigued (40%), applying
modalities (31%) and the least contributing factor was slipping/tripping/falling (12%).
(Table 3)
By using the Nordic questionnaire, the results revealed that the lower back has the most
incidence of musculoskeletal pain among physical therapists during the last 12 months
(88%) followed by upper back (66%), neck (60%), wrists/hands (21%), ankles/feet (20%),
shoulders (19%), knees (19%), hips/thighs (10%) and the least affected is elbows (7%).
(Table 3)
During the last 12 months, lower back was still the most affected part of the body that
prevented the respondents to carry out normal activities (22%) followed by wrists/hands
(14%), shoulders, (10%), upper back (10%), neck (6%), knees (6%), ankles/feet (6%),
hips/thighs (8%) and elbows (4%). (Table 3)
During the last 12 months, lower back was again the most affected part of the body that
forced the respondent to consult a physician (8%) followed by shoulders (6%), upper back
(6%), neck (2%), hips/thighs (2%), knees (2%) and ankles (2%). (Table 3)
And during the last 7 days, lower back was still the most affected part of the body that
the patient had trouble with (46%) followed by upper back (42%), neck (30%),
wrists/hands (20%), knees (14%), ankles/feet (14%), shoulders (10%), hips/thighs (8%)
and elbows (4%). (Table 3)
Improvements in body mechanics (92%), changing work positions frequently (62%),
and taking more rest breaks or pauses during the workday (54%) were the top three impacts
on work performance of the respondents followed by avoidance in lifting (42%), stop
working when hurt or when symptoms occur (26%), increase use of other personnel (24%),
encourage patient responsibility for carrying out treatment (22%), decrease manual
techniques (18%), increase use of mechanical aids (18%), change work schedule (overtime,
irregular shifts, length of workday) (12%) and no one responded increase administrative
time; decrease patient care time (0%). (Table 4)

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 IV. DISCUSSION
Work related musculoskeletal disorders are problems connected to occupational
conditions. Research has shown that musculoskeletal problems are particularly common
in health care workers who are in direct contact with patients. Physical therapists are in
high prevalence of WRMDs based on other popular studies.
The results from studies on WRMDs in physical therapists have generally been similar
according to prevalence, what body part is most affected, the possible risk factors and
impact to work performance. Considering the differences of practice in other countries, we
felt the need to conduct a study regarding WRMDs in Pampanga, Philippines.
In this study, we collected the demographic profile of the respondents and determined
the prevalence of WRMDs, possible risk factors that may contribute to acquire WRMDs
and the impact of WRMDs on physical therapists’ work performance from 50 physical
therapists working in selected private and government hospitals in Pampanga. We asked
the respondents to complete the demographic profile, Nordic questionnaire and a
questionnaire from the study “Work-related musculoskeletal disorders : A survey of
physical therapists in Izmir-Turkey”. The response rate of questionnaire was high (82.6 %)
in our study. 7 respondents were excluded in our study, 4 of the respondents have less than
one year of working experience and the remaining 3 are not full time physical therapists.
The survey answers revealed that 100% of the respondents had experienced WRMDs. A
study reported that younger physiotherapists have a higher prevalence of musculoskeletal
problems related to occupational conditions [24]. Another study also investigated low-back
pain in physiotherapists, and found an incidence of 66% in subjects between the ages of 20
and 40 years [26]. Studies of WRMDs in health care professionals have identified the lower
back as the most commonly involved area of the body, followed by neck and upper
extremities [27,28,29,30]. A study conducted by Bork and Holder et al. listed the regions
most commonly involved musculoskeletal injuries as the lower back, hand-wrist, and neck,
respectively among physiotherapists [26,31]. Lastly, a study also revealed that
physiotherapists tend to experience WRMDs at young age and it also reported that low
back is the most affected area of the body [39].
In relation with our study, all of our respondents (100%) in our study reported that they
have acquired musculoskeletal pain for the last 12 months showing that age is not a

12
contributing factor in contrary with the other studies mentioned above that young physical
therapists are at most risk in acquiring WRMDs.
On analyzing the different body parts affected in our subjects, we found the highest
frequency of musculoskeletal pain in the lower back (88%), followed by upper back (66%),
neck (60%) and wrists/hands (21%) now revealing similar results with the other studies as
mentioned above.
In other literatures that are related in our study, the job related factors that lead to
musculoskeletal pain in other health professionals are lifting heavy equipment and patients,
transferring patient, maintaining the same posture for a long period, manual therapy
practices, responding to patients' sudden movements, and repeated movements
[24,26,32,33,34 -36]. A study identified that staying in the same position for a long time
and continuing to work when tired are the main causes of WRMDs among physical
therapists [26]. While in another study, it also stated that lifting and leaning downwards
with sudden maximal effort are the main contributing factors in acquiring WMSDs [37].
And in another article, results shown that maintaining the same posture for a long time,
manual therapy, repeated movements, and increased work load are the main risk factors in
acquiring WRMDs [38]. Lastly, a study also stated that the main causes of WRMDs were
patient transfer, repeated movements, lifting heavy equipment, patients and working when
too physically tired. [39]
In relation to our study, work related musculoskeletal disorders were mainly caused by
lifting heavy equipment (84%), bending/twisting (62%), transferring a patient (62%),
performing repetitive tasks (54%) and maintaining a position for a prolonged period of
time (52%) showing same results with the other articles mentioned above.
Recent studies have shown that physical therapists who have suffered a WRMD tend
to change their professional attitudes to avoid additional injuries [39]. A study found that
81% of physical therapy assistants and 79% of physical therapists who had acquired
musculoskeletal pain on the job altered their work performance to avoid other WRMDs. It
has been reported that the most common strategies used by physiotherapists to avoid
WRMDs are correction of body mechanics, and frequent postural changes [26]. Another
study also reported that after acquiring a WRMD, improved body mechanics, avoided

13
lifting heavy equipment or patients, changed position frequently, and got other personnel
to help them were the common impact on their work performance [39].
In our study, it has been proven that the most common impact of WRMDs on physical
therapist’s work performance is improved proper body mechanics (92%) followed by
change working position frequently (62%), take more rest breaks or pauses during the
workday (54%).
Other health care professionals also have a very high prevalence rate of WRMDs and
this problem has led to more intensive research in recent years regarding WRMDs.
Primarily, health care workers need to be healthy physically to give quality service to the
people. These type of injuries has a large impact on health care professionals who are
rendering health care services for disabled people. Therefore, it is important to conduct
more studies with a goal of reducing and preventing WRMDs among physical therapists to
have better health care service.
Our study has few limitations such as the lack of correlation between frequency of body
area affected and the demographic profile of the respondents, the lack of knowledge if the
participant are truly diagnosed with WRMDs or is it just the most common body area that
they complain about. Thus, our demographic data became obsolete. Lastly the lack of
specification of questions when it comes to risk factors.

V. CONCLUSION
Our survey among physical therapists working in selected private and government
hospitals in Pampanga showed similarities in other countries who conducted the same
study despite difference in practice setting, working conditions and culture. It showed in
our study that WRMDs among physical therapists in Pampanga is highly prevalent since
all of the respondents reported that they acquired WRMDs during the last 12 months. It
also revealed that the demographic profile of the respondents cannot be concluded as a risk
factor in acquiring WRMDs. Thus, it is most commonly caused by lifting heavy equipment
and patients. And the most common impact of WRMDs on physical therapists’ work
performance is improved body mechanics. This study provides data related to WRMDs in
physical therapists in Pampanga, Philippines. Further studies can be very useful if it

14
research on more specific risk factors in acquiring WRMDs and having participants
medically diagnosed with WRMDs.

VI. ACKNOWLEDGEMENT
We would like to express our deepest appreciation to, Professor Pia Vanessa Basilio,
PTRP, for guidance when it comes study and providing encouragement and moral support
to our Research Team.
We also thank Carmelo Cunanan, Research Adviser, for encouraging to improve as
well as polish our thesis.
We are Grateful for Annalyn T. Navarro, College Dean of CAMP, for the privilege of
allowing us to conduct this study.
Lastly to the Private and Government Hospitals who were willing to participate in our
study.

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20
 APPENDIX A
ANGELES UNIVERSITY FOUNDATION
Angeles City, Philippines
College of Allied Medical Professions
Department of Physical Therapy

March 18, 2019

Mr. Roel Prado, PTRP
Jose B. Lingad Memorial Center
Chief Physical Therapist

Dear Sir:

We, Physical Therapy students of Angeles University Foundation, are currently conducting
a study entitled “Prevalence, Risk Factors and Impact of Work-Related Musculoskeletal Disorders
among Physical Therapist working in selected private and government hospitals in Pampanga. The
study aims to determine if there are any occurrence of WMSD among Physical Therapists working
in Private and Government Hospitals in Pampanga. Also, this study wants to identify factors that
could contribute to WMSD and its impact to Physical Therapists’ work performance.

In line with this, we would like to request that we would be allowed to conduct this research
in your facility, thru the use of questionnaires.

We hope that this request will merit your kind approval and we are looking forward to
work with you in making our Physical Therapists healthy and free from Work-Related
Musculoskeletal Disorders.

Sincerely yours:

Dungca, Vince Marc

Hernandez, Emil G.
Nucup, Ric Samuel D.
Salugao, Mark Angelo T.

Noted by:

Ms, Pia Vanessa Basilio, MPH, PTRP

Research Adviser
Chair, PT Department

Approved by:

Ms. Annalyn T. Navarro

Dean, College of Allied Medical Profession

21
 APPENDIX B
INFORMED CONSENT FORM
PREVALENCE, RISK FACTORS, AND IMPACT OF WORK RELATED
MUSCULOSKELETAL DISORDERS (WRMDs) AMONG PHYSICAL
THERAPISTS WORKING IN SELECTED PRIVATE AND GOVERNMENT
HOSPITALS IN PAMPANGA

Purpose and conduct of study

The purpose of this study is to determine the prevalence of WMSDs among PT
professionals working in private and government hospitals in Pampanga, to find out the
demographic risk factors that may contribute to acquire WMSDs and the impact of
WMSDs on physical therapist’s working work performance. To accomplish the purpose of
this study, a research will be conducted thru the use of questionnaires.

Participant’s information (nature and extent of involvement)

If you decide to participate in this study, you will be required to answer several
questions and share some personal information regarding the prevalence, risk factors and
impact of WMSDs on your work. During the survey, assistance will be given to you if there
are any clarifications. The target number of respondents is 70 Physical Therapist working
in hospitals.

Risk and inconveniences

In this study, you will not be involved in any risk. Although, there are some
questions that you may be required to share some personal information. No other
information will be collected other than what is asked on the questionnaires and pertinent
data will be used solely for the purpose of the study. On the average, it will take the
respondents 20 minutes to answer and complete the questionnaires during their vacant
hours.

Possible benefits for the participants

22
 There are no direct benefits involved in participating in the study. However,
identifying the WRMDs will be helpful in preventing its occurrence and modification of
activities or posture will be useful in making Allied Health Professionals free from
WMSDs. In participating with this survey, your honest and sincere response can help other
Allied Health Professionals to prevent acquiring WMSDs.
As an appreciation of your time in participating in the survey, a token will be
provided to you after completing the questionnaire.

Provisions for injury or related illnesses

This study will only involve a survey, therefore the occurrence of either injury or
illness as a result of your participation is very unlikely.

Contact person
If you have any questions regarding the study you may contact Angelo T. Salugao
at 09053769914 or at angelosalugao@yahoo.com

Voluntariness of participation
Your participation in this research study is completely voluntary. You have an
option to refuse in participating and have an option to withdraw from the study anytime
without any obligations.

Confidentiality and Data Management

We will make sure that your identity will remain confidential. Your personal
information provided such as contact number and/or e-mail address will be kept in private
and will be subjected with utmost confidentiality. All other pertinent information that you
have provided including answers to questions in the survey will be kept private and will be
used solely for the objective of the study. Actual survey forms and master list will be kept
for 1 year after the completion of the study and will be properly discarded thereafter but
the participants will have the rights to access their records from the study. The results of
the study will be stored in the AUF library after the study has been completed and will be
available for all students.

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 CONSENT FORM
I hereby confirm with that I have read the above information and all questions that
I have raised were properly answered and addressed to my contentment. I clearly
understand the nature of the study. I understand that my involvement in this project is
entirely voluntary and that I have the freedom to decline or withdraw anytime. I therefore
agree to participate in this study.

__________________ _______________________ ________________

Name of respondent Signature of respondent Date

STATEMENT OF THE RESEARCHER

I, the undersigned, have read out and explained properly to the participant all the
necessary information pertaining to this study. I hereby certify to the best of my ability that
the participant clearly understood the nature, corresponding risk in participating, and
benefits of the study. I confirm that the participant was given opportunity to ask questions
and clarify any issues related to the study and that all questions and issues raised were all
answered correctly and appropriately to the best of my knowledge. I further confirm that
the participant was not forced into the provision of consent and that the aforementioned
permission was given voluntarily.

__________________ _______________________ ________________

Name of researcher Signature of researcher Date

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 APPENDIX C
The title of the study is “Prevalence, Risk Factors and Impact of Work Related
Musculoskeletal Disorders among Physical Therapists working in selected Private and
Government Hospitals in Pampanga”. The key purpose of the study is to determine if there are
any occurrence of WMSD among physical therapists working in private and government hospitals
in Pampanga. Also, this study wants to identify factors that could contribute to WMSD and the its
impact to physical therapist’s work performance.
In connection with this, may we request that you give your full support in this endeavor by
providing and answering all the questions contained in the questionnaire. Also we would ask for a
complete and truthful answer so that we can gather the necessary information. We reassure you that
your response will be treated with utmost confidentiality. Thank you and God bless.

Please fill out the blanks with the space provided.

Demographic Profile

Type of Hospital Affiliated: Private ____ Government ____

Age: _____ Duty Hours: _____

Sex: _____ Number of patients/day: _____

Height (ft): _____ Working years in current hospital: _____

Weight (kg): _____

Which among these job related factors caused you to have musculoskeletal pain? Please check [/]
all that apply.
___ Applying Modalities
___ Bending/Twisting
___ Lifting heavy equipments or patients
___ Slipping/Tripping/Falling
___ Maintaining a Position for a Prolonged Period of Time
___ Performing Manual Therapy Techniques
___ Working in an Awkward or Cramped Position
___ Responding To an Unanticipated or Sudden Movement by a Patient
___ Working When Physically Fatigued
___ Performing Repetitive Tasks
___ Transferring a Patient
Others: Please specify: _____________

25
How to answer the questionnaire: Please answer by putting a check [/] in the appropriate box- one
check for each question. You may be in doubt as how to answer, but please do your best anyway.
Please answer every question even if you have never had trouble in any part of your body. In this
picture, you can see the appropriate position of the parts of the body referred to in the questionnaire.
Limits are not sharply defined and certain parts overlap. You should decide for yourself in which
part you have or have had your trouble (if any).

Which among these work activities were altered because of the musculoskeletal pain? Please check
[/] all that apply.
___ Avoid Lifting
___ Change Working Position Frequently
___ Change Work Schedule (Overtime, Irregular Shifts, Length of Workday)
___ Decrease Manual Techniques
___ Encourage Patient Responsibility for Carrying Out Treatment
___ Increase Use of Mechanical Aids
___ Increase Administrative Time; Decrease Patient Care Time
___ Increase Use of Other Personnel
___ Stop Working When Hurt or When Symptoms Occur
___ Take More Rest Breaks or Pauses during the Workday
___ Use Improved Body Mechanics

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 APPENDIX D
CURRICULUM VITAE
Name: Mark Angelo T. Salugao
Address: 255 Tongol St. San Isidro Minalin, Pampanga
2019
Contact No.: 0905-376-9914
Email address: Angelosalugao@yahoo.com
School: Angeles University Foundation

PERSONAL DATA

Nationality: Filipino
Sex: male
Marital Status: Single
Date of Birth: September 7, 1995
Place of Birth: Minalin, Pampanga

EDUCATION

2014-2019: BS Physical Therapy, Angeles University Foundation

2010-2014: Kodiak High School, Kodiak Alaska
2004-2010 Main Elementary, Kodiak Alaska

AFFILIATIONS:

February 2019 Has successfully completed internship training at Angeles University Foundation
Educational Management
January 2019 Has successfully completed internship training at Armed Forces Philippines Health
Service Command
November 2018 - Has successfully completed internship training at Philippine Orthopedic Center.
December 2018
September 2018 - Has successfully completed internship training at Angeles University Foundation
October 2018 Medical Center.
August 2018 Has successfully completed internship training at Philippine Cerebral Palsy
Incorporated.
July 2018- Has successfully completed internship training at Summit Wellness Center.
May-June 2018 Has successfully completed internship training at Angeles University Foundation
Magalang Community Based Rehabilitation.

27
 CURRICULUM VITAE
Name: Ric Samuel D. Nucup
Address: #6 Bettina Alley Paradise Compound, Angeles
City
Contact No.: 09951832550
Email address: ricsam720@yahoo.com
School: Angeles University Foundation

PERSONAL DATA

Nationality: Filipino
Sex: Male
Marital Status: Single
Date of Birth: September 7, 1996
Place of Birth: Angeles City

EDUCATION

2014-2019: BS Physical Therapy, Angeles University Foundation

2009-2014: Secondary Education, Claro M. Recto Information And Communication Technology High
School
2003-2009: Primary Education, Achievers Special Education Center

HONORS AND AWARDS

2014: 6th Honorable Mention (Graduating Class)

2009: With Honors (Graduating Class)

AFFILIATIONS:

February 2019 Has successfully completed internship training at Angeles University Foundation
Educational Management
January 2019 Has successfully completed internship training at Armed Forces Philippines Health
Service Command
November 2018 - Has successfully completed internship training at Philippine Orthopedic Center.
December 2018
September 2018 - Has successfully completed internship training at Angeles University Foundation
October 2018 Medical Center.
August 2018 Has successfully completed internship training at Philippine Cerebral Palsy
Incorporated.
July 2018- Has successfully completed internship training at Summit Wellness Center.
May-June 2018 Has successfully completed internship training at Angeles University Foundation
Magalang Community Based Rehabilitation.

28
29