Lessons to be learned: a retrospective analysis of physiotherapy injury claims

J Orthop Sports Phys Ther. 2012 Aug;42(8):698-704. doi: 10.2519/jospt.2012.3877. Epub 2012 Jun 18.


Study design: Retrospective, descriptive analysis.

Objectives: To describe the prevalence and nature of insurance claims for injuries attributed to physiotherapy care.

Background: In New Zealand, a national insurance scheme, the Accident Compensation Corporation, provides comprehensive, no-fault personal injury coverage. The patterns of injury sustained during physiotherapy care have not previously been described.

Methods: De-identified data for all injuries registered with the Accident Compensation Corporation from 2005 to 2010 and attributed to physiotherapy were accessed. Prevalence patterns (percentages) of new-claim data were determined for physiotherapy intervention category, injury site, nature of injury, age, and sex. A subcategory, exercise-related injuries, was analyzed according to injury site and whether the injury was related (primary) or unrelated (secondary) to the intended therapeutic goal.

Results: There were 279 claims related to physiotherapy care filed with the Accident Compensation Corporation during the studied reporting period. Injury was attributed predominantly to exercise (n = 88, 31.5% of cases) and manual therapy (n = 74, 26.5% of cases). The prevalence of events categorized as exercise related was greatest in those who were 55 to 59 years of age (n = 14, 16.3%) and greater in females (n = 47, 54.7%). Of the exercise-related injuries, 39.8% were in the lower-limb region and 35.2% were categorized as sprains/strains.

Conclusion: Injuries attributed to exercise exceeded those linked to other therapies provided by physiotherapists, yet exercise therapy rarely features as a cause of adverse events reported to the physiotherapy profession. The proportion of exercise-related injury events underlines the need for ensuring safe and careful consideration of exercise prescription.

Level of evidence: Harm, level 4.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Humans
  • Iatrogenic Disease / epidemiology*
  • Insurance Claim Reporting / trends
  • Insurance Claim Review / statistics & numerical data
  • Male
  • Middle Aged
  • Musculoskeletal Manipulations / adverse effects*
  • Musculoskeletal Manipulations / statistics & numerical data
  • New Zealand / epidemiology
  • Retrospective Studies
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / etiology