Cumulative trauma disorders

focus of evaluations

• Individual worker • Specific job tasks • Individual capabilities

ergonomic task analysis

• Job analysis evaluation • Examine the impact that the job has the person's system - Work station - Posture - Physical demands • What can be done to decrease the risk of cumulative trauma? - easier to change environment than employee behavior, but employer may not want to spend the money to make changes

occupations at risk

• Meat packing industry • Grocery store clerks • Assembly line workers • Computer operators • Wiring • Carpentry • Card dealers

CTD diagnoses

• Medial and lateral epicondylitis • Bursitis • Tendonitis • Thoracic outlet syndrome • Carpal tunnel syndrome • DeQuervains Tenosynovitis • Ganglion cysts

examination for CTDs

• PT tests and measures: - Strength, ROM, Pain, • Special tests - Tinel's sign - Phalen's test - Finkelsteins test • Important components: - Posture - Ergonomics • must address underlying cause, not just the impairment

keys to prevention

• Participation of: - Worker - Management - Supervisors • Education must be directed at the level of the worker

PT involvement

• Patient education • Content: - Anatomy of the joint - Disease process - Job modification - Energy conservation - Body mechanics - Joint protection - Proper posture

prevention of CTDs

• Primary - when starting a new company - stretching/strengthening programs, teaching good lifting techniques • Secondary - if you commonly see the same injury, make a change to prevent more/worsening injuries • Tertiary

recommendations for pediatric athletes

• Proper training is essential • Take 1-2 days off per week • 2-3 months off per year from a particular sport • Focus should be on wellness

occupational factors

• Repetitive exertions • Forceful exertions • Stressful postures • Low temperatures • Vibration • Poorly designed work stations - designed for efficiency, not comfort • Production rates and incentive programs • Poorly maintained equipment

ergonomics

• Study of the interaction between human beings and the objects they use and the environment in which they function • Fitting the task to the person • Types of problems: - Anthropometric - Cognitive (Information overload or underload) - Musculoskeletal - Cardiovascular - Psychomotor

computer monitor positioning

• top of screen at eye level • monitor directly in front of face

CTDs in pediatric and adolescent athletes

• 30-45 million participate • 50% of all injuries are related to overuse • Many children participate in the same sport year round • Pressure from parents may lead to overtraining

study on implementation of recommended changes

• 89.3% of employees fully or partially implemented recommendations - Using available equipment - Changing posture - Altering work pace • Supervisor responsible for administrative or equipment changes - 69.4% of recommendations were implemented • Behavior changes significantly more likely to be implemented

statistics about CTDs

• Affect 19 million individuals per year • 66% of workforce illnesses • Costs nation 13-20 billion dollars annually - Lost work - Compensation claims • Carpal tunnel syndrome - 49,000 cases in 2000 - Women affected 70% of time - ~25 days of lost work

strategies to prevention

• Change employee behavior - Barriers: habit, lost incentives if behavior change impacts productivity • Change physical environment - Barriers: cost, required time, requires involvement of other individuals

non-occupational factors

• Congenital defects • Chronic diseases • Age • Gender • Recreational interests • History of UE injury

psychological impact of CTDs

• Decreased sense of control over symptoms • Loss of function • Loss of income • Impaired relationships with coworkers • Strain on family

cumulative trauma disorders (CTDs)

• Disorders caused, precipitated, or aggravated by repeated exertions or movements • Also known as: - Repetitive strain injury (RSI) - Occupational overuse syndrome (OOS) - Repetitive trauma disorder (RTD) - Work-related musculoskeletal disorders (WMSDs) • Can occur in any area of the body - Hand/wrist, Shoulder, Neck/upper back, Low back, Lower extremity • Major causes: - Fixed work postures with repetitive motions - Psychological stress (increased multi-tasking and attentional demands)

workplace screening

• Does your job require you to: - Repeatedly bend and twist your wrists? - Repeatedly hold your elbows away from your body? - Repeatedly use a pinch grip? - Repeatedly reach behind your body? - Repeatedly reach or lift things above your body? - Repeatedly reach or lift items above shoulder level? - Repeatedly use a tool that vibrates? - Repeatedly use your hand as a hammer? - Repeatedly twist or flex your body? - Repeatedly lift objects from below knee level? - Repeatedly work with your neck bent? • How much time is spent in a static position? • How many hours are spent in front of a visual display terminal or computer? • How often does your job require you to perform this task?

significant involvement with:

• Employees are being injured • Production volume is high • Labor turnover is high • Workplace is utilized for >1 shift

indicators for ergonomic attention

• Frequent employee mistakes • High employee turnover • Production is low • Absenteeism is high • Low quality work • High number of visits to employee health • Breaks are long