Análise ergonômica da formação de estudantes de fisioterapia de uma universidade brasileira: uma proposta de prevenção de LER/DORT

Abstract

It is reported in several studies that physical therapy is a profession with high prevalence of Repetitive strain injury and Work-Related Musculoskeletal Disorders (RSI-WRMD). The first contact between the physical therapist and the RSI-WRMD risk factors occurs throughout their lives, but during their training, when still a student of Physiotherapist, this exposure to risk remains, without due precautions, in an environment that should worry about preventing. During the professional learning phase, the students adopt constant forced postures and biomechanical efforts, transfer and manual elevation of patients, sudden efforts, among others, generating discomforts, pain and musculoskeletal injuries. An injury in therapist can force him to have to work with pain, to have to change the operative ways of work, to restrict the variety of clinical conduct and, consequently, to anticipate the interruption of the professional career. This research aims the formation of university students of Physiotherapy, who perform professional internship and to elaborate guidelines to prevent RSI-WRMDs. Ergonomic Analysis of Work was taken as a methodological reference. For that, the documentary analyzes related to the Political Pedagogical Project of the Course of Physiotherapy, the curriculum grid, the course plan and the discipline's agenda were searched for evidence of policies, guidelines and forecast of approaches to contents and of professional practices related to the prevention of RSIWRMD. Also conducted interviews with the students, teachers and course coordinator, and audio-visual records of the student in attendance and the infrastructure of the places of attendance. It was verified that the Pedagogical Project of the course in focus had the discipline of Worker's Health only formally and did not find, in Political Pedagogical Project of the Course, no programmatic content related to the prevention of RSI-WRMD and the self-care directed to occupational health of the students themselves. The students reported that did not receive any specific classes of RSI-WRMD prevention, self-care, ergonomics, occupational health and safety, or related subjects. However, the self-care guidelines they received from teachers were diluted in some disciplines. The guidelines that the students reported receiving in these disciplines consisted of: correcting stretcher height, using a better force lever, being careful in bending and spinal rotation and to have careful in handling loads. Students gained knowledge of RSI-WRMD prevention only for the patient and spontaneously realized that they could transfer this knowledge, acquired in another context, in the management of their self-care. However, most of the students interviewed claimed that they could not implement the RSI-WRMD prevention guidelines, because of the burden of study and fatigue after care. The specialty of the professional stage, cited by the students interviewed, in which they presented the greatest complaint of pain, was that of neurology, mainly because of the transfer actions, from one place to another, of dependent and heavy patients. These actions are oftentimes individually made and without mechanical assistance. No RSI-WRMD-prevention guidelines or programmatic content were given by the teachers to the students during the internships. It was also found that there is a high incidence of reports of pain among senior students of physical therapy and the lack of a RSI-WRMD-prevention plan can let the students to reproduce pathogenic behaviors during the professional life, which consequently leads them to injures or early incapacitate. Therefore, it is recommended the periodic evaluation of the musculoskeletal system of the students, preventive clinical actions and the inclusion of a specific discipline and/or cross-curricular content in all disciplines, providing students with knowledge about the possible causes of the onset and aggravation of RSI-WRMD, the importance of prevention and possible prevention measures and the relationship of this approach with the efficiency of the physiotherapeutic act and, consequently, with the treatment results of the patient treated by the student. This allows the student in professional formation to act with better efficiency, health and safety, integrated. And that, in their professional life, this knowledge and good practices be assimilated, thus avoiding a bad mirror effect inherited from incomplete university education.