Frequency of musculoskeletal disorders, use of diagnostic studies, and time to initiation of rehabilitation in an outpatient physiotherapy service at a public hospital in the Autonomous City of Buenos Aires: a retrospective descriptive study
Abstract
Objective: To describe the frequency and characteristics of musculoskeletal disorders (MSDs) in subjects who initiated outpatient rehabilitation at a public hospital in the Autonomous City of Buenos Aires, in accordance with STROBE-SIIS (Strengthening the Reporting of Observational Studies in Epidemiology for Sports Injury and Illness Surveillance). Secondary objectives were to quantify the time from medical referral to the first physiotherapy consultation and to describe the use of diagnostic studies according to anatomical region and type of injury, distinguishing between specific and nonspecific injuries.
Materials and methods: A descriptive, retrospective, and cross-sectional study. Medical records of subjects aged ≥18 years who initiated rehabilitation between November 2023 and June 2025 were analyzed. Diagnoses were classified according to STROBE-SIIS, considering anatomical region, segment, affected tissue, and injury type.
Results: A total of 901 subjects were included. The most affected regions were the lower limb (38.51 %), upper limb (34.30 %), and trunk (17.09 %), with 347, 309, and 154 MSDs, respectively. Nonspecific injuries were the most frequent (420 subjects; 46.61 %), followed by tendinopathies (166; 18.42 %), and fractures (117; 12.99 %). The median time to initiation of rehabilitation was 25 days (IQR 15-32). A total of 711 subjects (82.90 %) had at least one diagnostic study.
Conclusion: In the public setting, subjects with MSDs who initiated rehabilitation were characterized by a high frequency of nonspecific injuries, high use of diagnostic studies regardless of injury type, and delays of approximately four weeks before starting treatment.
References
1. Safiri S, Kolahi AA, Cross M, Hill C, Smith E, Carson-Chahhoud K, et al. Prevalence, deaths, and disability-adjusted life years due to musculoskeletal disorders for 195 countries and territories 1990–2017. Arthritis Rheumatol. 2021;73(4):702-714.
2. Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease Study 2019: a systematic analysis. Lancet. 2020;396(10267):2006-2017.
3. Bevan S. Economic impact of musculoskeletal disorders (MSDs) on work in Europe. Best Pract Res Clin Rheumatol. 2015;29(3):356-373.
4. Belló M, Becerril-Montekio, VM. Sistema de salud de Argentina. Salud Publica Mex. 2011;53(Suppl 2):S96-S103.
5. Ballesteros MS. Desigualdades sociales en los tiempos de espera para la consulta médica en Argentina. Gerenc Polit Salud. 2016;15(30):1-15.
6. Zadro JR, Décary S, O’Keeffe M, Michaleff ZA, Traeger AC. Overcoming overuse: improving musculoskeletal health care. J Orthop Sports Phys Ther. 2020;50(3):113-115.
7. Karel YHJM, Verkerk K, Endenburg S, Metselaar S, Verhagen AP. Effect of routine diagnostic imaging for patients with musculoskeletal disorders: a meta-analysis. Eur J Intern Med. 2015;26(8):585-595.
8. Soliño S, Calvo Delfino M, De La Rúa M, Mignone F, Navarro E, Pierobon A, et al. Prevalencia de estudios complementarios en sujetos con afecciones de columna en un hospital público de la Ciudad Autónoma de Buenos Aires. AJRPT. 2022;4(2):32-9.
9. Soriano ER, Zingoni C, Lucco F, Catoggio LJ. Consultations for work-related low back pain in Argentina. J Rheumatol. 2002;29(5):1029-1033.
10. Noli EM, Aguirre P, Bertozzi M, Carroll S, Castro D, Covello G, et al. Prevalencia de los motivos de consulta y las características de los sujetos en un consultorio externo de kinesiología de un hospital público de la Ciudad de Buenos Aires. AJRPT. 2020;2(3):12-21.
11. Muhafara GJ, AJ, Tozzi WA, Villarruel M, Sacha Ali V, Mariano A, et al. Prevalence of musculoskeletal disorders of the shoulder in a hospital of the City of Buenos Aires: a retrospective study. Acta Shoulder Elbow Surg. 2017;2(2):1-7.
12. Pierobon A, Policastro P, Ponce Amorín M, Navarro E, Méndez D, Raguzzi I. Epidemiología de sujetos con afecciones músculo-esqueléticas que acuden a un consultorio privado de kinesiología en Argentina. AJRPT. 2020;2(2):28-35.
13. International Olympic Committee Injury and Illness Epidemiology Consensus Group; Bahr R, Clarsen B, Derman W, Dvorak J, Emery CA, Finch CF, et al. International Olympic Committee Consensus Statement: Methods for Recording and Reporting of Epidemiological Data on Injury and Illness in Sports 2020 (Including the STROBE Extension for Sports Injury and Illness Surveillance (STROBE-SIIS)). Br J Sports Med. 2020;54(7):372-389.
14. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007 Oct 20;370(9596):1453-7.
15. Qaseem A, Wilt TJ, McLean RM, Forciea MA, Clinical Guidelines Committee of the American College of Physicians, Denberg TD, et al. Noninvasive treatments for acute, subacute, and chronic low back pain. Ann Intern Med. 2017;166(7):514-530.
16. Ludewig PM, Lawrence RL, Braman JP. What’s in a name? Using movement system diagnoses versus pathoanatomic diagnoses. J Orthop Sports Phys Ther. 2013;43(5):280-283.
17. Gorce P, Jacquier-Bret J. Global prevalence of musculoskeletal disorders among physiotherapists: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2023;24(1):265.
18. Haas R, Gorelik A, Busija L, O’Connor D, Pearce C, Mazza D, et al. Prevalence and characteristics of musculoskeletal complaints in primary care: an analysis from the population level and analysis reporting (POLAR) database. BMC Primary Care. 2023;24(1):40.
19. Martin S, Smith M, Wilson DA, Zadro JR, Ferreira GE, O’Keeffe M. Non-specific diagnostic labels for musculoskeletal conditions: a systematic review. J Physiother. 2025;71(3):167-178.
20. Pike A, Patey A, Lawrence R, Aubrey-Bassler K, Grimshaw J, Mortazhejri S, et al. Barriers to following imaging guidelines for low back pain in primary care. BMC Prim Care. 2022;23(1):143.
21. Deslauriers S, Raymond MH, Laliberté M, Lavoie A, Desmeules F, Feldman DE, et al. Access to publicly funded outpatient physiotherapy services in Quebec. Disabil Rehabil. 2017;39(26):2648-2656.
22. Passalent LA, Landry MD, Cott CA. Wait times for publicly funded outpatient physiotherapy and occupational therapy services in Ontario. Physiother Can. 2009;61(1):5-14.
23. Chen Y, Campbell P, Strauss VY, Foster NE, Jordan KP, Dunn KM. Trajectories and predictors of the long-term course of low back pain. Pain. 2018;159(2):252-260.
24. Thomas MJ. Expanding and explaining symptoms in knee osteoarthritis trajectories. Osteoarthritis Cartilage. 2023;31(6):725-726.
25. Irgens P, Myhrvold BL, Kongsted A, Waagan K, Engebretsen KB, Vøllestad NK, et al. The clinical course of neck pain: trajectory patterns over 1 year. Eur J Pain. 2022;26(2):531-542.
26. Deslauriers S, Déry J, Proulx K, Laliberté M, Desmeules F, Feldman DE, et al. Effects of waiting for outpatient physiotherapy services: a systematic review. Disabil Rehabil. 2021;43(5):611-620.
27. Argentina. Ley 24.317. Modificación al Código Penal, incorporación de los artículos 149 bis y 149 ter [Internet]. Boletín Oficial de la República Argentina; 1994 [citado 25 ago 2025]. Disponible en: https://www.argentina.gob.ar/normativa/nacional/ley-24317-716/texto
28. Long J. European region of the WCPT statement on physiotherapy in primary care. Prim Health Care Res Dev. 2019;20:e147.
