Jenkins, Heather Theresa2014-03-312014-03-312014-03-31http://hdl.handle.net10539/14431Of all the structures in the hand, the thumb is the most vulnerable to biomechanical and work-related injuries in physiotherapists using manual therapy techniques. The objectives of the current study were to determine the prevalence and factors associated with work – related thumb problems (WRTP) in South African physiotherapists and establish the strategies they used in the management of the thumb problems. A cross-sectional, descriptive study design was used and data were collected using an internet-based questionnaire. The life-time prevalence of WRTP in South African physiotherapists using manual therapy techniques was 65.3% in survey one and 67.5% in survey two. The factors that were significantly associated with WRTP in all 395 respondents were hyperextension >10° of the knee on the non-dominant side (p=0.02), passive F of the thumb to the anterior forearm (p=0.04), hyperextension >30°of the nondominant IP joint of the thumb (p=0.02) and the treatment of more than six patients a day with manual therapy to the cervical spine (p=0.02). The factors that were significantly associated with WRTP in all 395 respondents in the univariate analysis were put in a regression analysis. The factors that remained significantly associated with WRTP were the cervical treatment of up to six patients a day (p=0.01) and hyperextension>30° of the non-dominant IP joint of the thumb (p=0.05). The factors that were significantly associated with WRTP in the 258 respondents who had WRTP were all grades of transverse glides applied to the spine (p<0.001), grade II-IV unilateral and central posterior-anterior pressures to the spine (p< 0.001), Additional occupational factors significantly associated with WRTP (p<0.001) included an increase in thumb use in the performance of manual techniques, inadequate training in injury prevention, a high, repetitive workload, working with a current injury, working in sustained, uncomfortable positions, inadequate rest periods, working at or near your physical limits and manual chest physiotherapy (p=0.005).The strategies most commonly used by the physiotherapists in the management of the WRTP were the modification of the technique and the use of a different technique. Randomised control trials are recommended to investigate the effectiveness of the preventative and management strategies of WRTP in physiotherapists.enThesis