Taking Preventative Steps to Avoid Work Related Injuries of the Upper Extremity Chelsea Lee, OTS...
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Transcript of Taking Preventative Steps to Avoid Work Related Injuries of the Upper Extremity Chelsea Lee, OTS...
Taking Preventative Steps
to Avoid Work Related
Injuries of the Upper
Extremity
Chelsea Lee, OTS
January 23, [email protected]
ASOT 2015 Vision and Action Conference
Level II FieldworkKentucky Hand and Physical Therapy (KHPT)Lexington, KY
Lee Memorial Hospital Acute RehabFt. Myers, FL
Work Related Injuries (WRI)
• Work Related Upper Extremity Disorders (WRUED)
• Upper Extremity Work Related Musculoskeletal Disorders (UE-WRMSD)
• Cumulative Trauma Disorders (CTD)
• Repetitive Strain Injuries (RSI)
• Repetitive Trauma Disorders (RTD)
• Repeated Motion Disorders (RMD)
• Overuse Syndrome
Research Question
• For individuals in the workplace, will practicing joint protection techniques using ergonomics, as compared to no intervention, significantly decrease work related upper extremity disorders?
Why should we care?
• WRIs are costing employers an estimated $1 billion per week in the United States
• Occupational therapists can drastically reduce these costs by:• Education on:
• Ergonomics• Behavioral Changes• Joint Protection Techniques
• We ALL overuse and abuse our joints…yes even YOU!
Everyday Activities
Thumb extension and abduction=stress on CMC joint
Prolonged neck flexion=stress on Atlanto-Occipital Joint
Uneven weight distribution=stress on Gleno-Humeral joint
Current Research
• Research Article 1 Darragn, A. R., Harrison, H., & Kenny S. (2008)
• Interventions: Group 1: Control Group
Group 2-Education only Group 3: Education and OT intervention
• Outcomes: Improved body positioning, body mechanics, and workstation design
• Research Article 2 McCormack, S. (2010)
• Interventions: Ergonomics and Behavioral• Outcomes: Client demonstrated improved posture
and improved behavior habits, reported decreased elbow pain with keying and mousing, and increased activity tolerance.
Current Research
• Research Article 3 Buchi, S., Bie, R.A., Ciurea, A., Kubli, R., Niedermann, K., Steurer-Stey, C., & Villiger, P. M. (2010)
• Interventions:Control Group: Conventional JP educationIntervention Group: PRISM-based JP education-consisted of standardized JP education but much more individualized and based on the PRISM tasks, the social learning, and self management. • Outcomes:Individualized, resource-oriented psycho-educational JP education (PRISM-JP) supported the acquisition and maintenance of JP behavior more successfully than C-JP.
Clinical Relevance
• Look at the person as a WHOLE, rather than just an extremity
• Saves clients time and money
• Saves employers time and money
• Educate, educate, EDUCATE• Ergonomics• Behavioral Changes• Joint Protection Techniques
Ergonomics
• Keyboards• Various keyboards available to help reduce
pain from CTDs• Correct Mouse Posture
• Relaxed Grasp• Movement distributed throughout arm
• Locations• Place items used frequently within arms reach• Stand up to retrieve items placed overhead
Behavioral Changes
• Breaks• Every 10-20 minutes stretch!
• Change positions• Every 30-60 minutes-change positions
Set a timer if needed to remember!
6 Principles of Joint Protection
• 1. Respect Pain
• 2. Balance Rest and Activity
• 3. Exercise in a Pain Free Range
• 4. Avoid Positions of Deformity
• 5. Reduce the Effort and Force
• 6. Use Larger/Stronger joints
Joint Protection Principles
Beasley, 2013, p. 459
References• Beasley, J. (2013). Arthritis.In C. Cooper (Ed.), Fundamentals of Hand Therapy: Clinical Reasoning
and Treatment Guidelines for Common Diagnoses of the Upper Extremity. (pp. 459-469). St. Louis, MO: Elsevier
• Buchi, S., Bie, R.A., Ciurea, A., Kubli, R., Niedermann, K., Steurer-Stey, C., & Villiger, P. M. (2010) Effectiveness of individual resource-oriented joint protection education in people with rheumatoid arthritis. A randomized controlled trial. Patient Education and Counseling, 82, (42-48) doi: 10.1016/j.pec.2010.02.014
• Darragn, A. R., Harrison, H., & Kenny S. (2008) Effect of an ergonomics intervention on workstations of microscope workers. American Journal of Occupational Therapy, 69, 61-69.doi: 10.5014/ajot.62.1.61
• Hammond, A., & Freeman, K. (2004). The long-term outcomes from a randomized controlled trial of an educational–behavioural joint protection programme for people with rheumatoid arthritis. Clinical Rehabilitation, 18(5), 520-528. doi:10.1191/0269215504cr766oa
• McCormack, S. (2010). Ergonomic and behavioral interventions as the primary treatment for work-related lateral epicondylitis. Work, 37(1), 81-86. doi:10.3233/WOR20101059
• Ripat, J., Giesbrecht, E., Quanbury, A., & Kelso, S. (2010). Effectiveness of an ergonomic keyboard for typists with work related upper extremity disorders: A follow-up study. Work, 37(3), 275-283. doi: 10.3233/WOR-2010-1079
• Ripat, J., Scatlif, T., Giesbrecht, E., Quanbury, A., Friesen, M., & Kelso, S. (2006). The effect of alternate style keyboards on severity of symptoms and functional status of individuals with work related upper extremity disorders. Journal of Occupational Rehabilitation, 16, 707-718. doi:10.1007/s10926-006-9054-z.
• Soares, M. M., Jacobs, K., Levanon, Y., Gefen, A., Lerman, Y., Givon, U., & Ratzon, N. Z. (2012). Multi dimensional system for evaluating preventive program for upper extremity disorders among computer operators. Work, 41669-675. doi: 10.3233/WOR-2012-0224-669
Questions?