Preven+ng Carpal Tunnel & Other Work Related Injuries

Transcription

1 Objec+ves At the end of this session, par+cipants will be able to: Preven+ng Carpal Tunnel & Other Work Related Injuries Anne M. Haskins, PhD, OTR/L Department of Occupa+onal Therapy 1. Iden+fy physical and psychosocial factors that contribute to musculoskeletal injuries in the workplace. 2. Conduct a personal worksta+on ergonomic assessment. 3. Develop a personalized plan to prevent musculoskeletal injuries at work. Musculoskeletal Disorder Overview Musculoskeletal Disorders Defined Prevalence The Most Common Medical Condi1ons in the U.S. 1. Musculoskeletal Disorders 2. Emo+onal Disorders 3. Circulatory Disorders 4. Respiratory Disorders American Associa+on of Orthopedic Surgery,

2 Specifically Speaking 1. Chronic Pain 2. Arthri+s 3. Neck Pain 4. Lower Back Pain 5. Low Back Pain Below Knee Lost Work Days Due by Medical Condi1on 52.22% due to Back/Neck Pain and Chronic Joint Pain / Arthri+s American Associa+on of Orthopedic Surgery, 2011 American Associa+on of Orthopedic Surgery, 2011 Total Produc1vity Loss Total Produc1vity Loss By Specific Musculoskeletal Condi1on American Associa+on of Orthopedic Surgery, 2011 American Associa+on of Orthopedic Surgery,

3 Common Disorders Carpal Tunnel Syndrome Lateral Epicondyli+s Ulnar Neuropathy Rotator Cuff Pathologies Shoulder, Neck & Back Pain E+ology (aka Causes) Anatomy/Physiology/Gene+cs Physical Exer+on/Overuse Psychological Stress Nutri+on Jacoby et al., 2011; Thompson, 2008 Physical Risk Factors are present in every job regardless of perceived physicality. Risk Factors for Injury Mo+ons & tasks that are. F - Forceful A Awkward V - Vibratory R Repe++ve S - Sustained Especially when mo+ons are outside of the neutral zone Jacoby et al.,

4 Addi+onal Environmental Considera+ons Noise Ligh+ng Contact Stress PREVENTION Maltchev, 2012 Ergonomics Ergonomics is the study of humans, objects, or machines, and the interac+ons among them (Maltchev, 2012, p. 304). Customizing Workspaces & Work Rou+nes hip:// v=pi6brtttgey 4

5 Worksta+on Analysis e- Tools Computer Worksta+on Assessment Worksta+on Analysis e- Tool hips:// computerworksta+ons/index.html Ergonomics case study (awesome) - Desk hip:// Ergonomic Checklist hips:// computerworksta+ons/checklist.html Lioing hip:// feature=player_embedded&v=j9kgjwkvcie Take Aways Maintain a straight spine Wide stance Keep item close to the body For awkward items Add handles or ask for help Maintain the neutral zone PERCEIVED WORKPLACE STRESSORS What are a few that are present in your workplace? 5

6 Stressors Americans & Stress (American Psychological Associa+on, 2009) Bio- ecological Psychointrapersonal*** Social Stressors Money Work Rent/Mortgage Balancing Work/ Family/ Personal Time Effects Physical Symptoms Psychological Symptoms Sleep Disturbance Seaward, 2006 Mind- Body Connec+on PSYCHOPHYSIOLOGY Of Stress Systems Nervous CNS PNS ANS Endocrine Immune Musculoskeletal System Interplay Endocrine System Immune System Nervous System Cogni+ve Percep+on of S+muli Seaward,

7 Disease & Stress 80% of Dr. visits are the result of stress % of health- related problems are either precipitated or aggravated by stress. Seaward, 2006 Nervous System Bronchial asthma Tension & migraine headaches Temporomandibular joint dysfunc+on Irritable bowl syndrome Coronary heart disease Immune System The common cold Influenza Allergies Rheumatoid Arthri+s Ulcers & coli+s Cancer Musculoskeletal System Disorders At Work REDUCING STRESS Preven+on Primary Preven+on Areas Primary Preven+on The implementa+on of ergonomics solu+ons involving par+cipa+on of the worker and other workplace staff, such as the supervisor. Secondary Preven+on Interven+on that is undertaken aoer individuals have experienced a condi+on of concern. Ter+ary Preven+on Interven+on designed for individuals with chronically disabling musculoskeletal disorders with the goal of achieving maximal func+onal capacity. Ergonomics Work and Environmental Design Work load and work pace Working hours Interpersonal rela+onships Social environment Organiza+on and Management Development Par+cipa+on, role and control Job design Job descrip+ons Culture Career development Communica+on Clear organiza+onal structure and prac+ces 7

8 Secondary Preven+on Areas Worker Educa+on and Training Ergonomics Improve equipment used and physical working condi+ons Safety Stress management Time management Build managers understanding of work stress and their skills to deal with it effec+vely Job specific training with effec+ve supervision and guidance Ensure employees have or develop the appropriate knowledge and abili+es to perform their jobs effec+vely Ensure employees know what exactly their job is: job descrip+ons Healthy Methods of Managing Stress Differen+ate between true stressors & an automa+c reac+on. Avoid controllable stressors Plan Say No Priori+ze Exercise Sleep Well Na+onal Ins+tute of Health, 2007 Ter+ary Preven+on Areas Ter+ary Preven+on Areas Exercise! At work At home Developing more sensi+ve and responsive management systems and enhanced occupa+onal health provision. Current Research Tveito & Eriksen (2008); Kuopalla (2008) 8

9 Adults need at least (Centers for Disease Control, 2008) Cardiovascular Exercise 2 hours & 30 minutes of moderate- intensity aerobic ac+vity/week AND v 1 hour & 15 minutes of vigorous- intensity aerobic ac+vity /week AND Ø An equivalent mix of moderate and vigorous- intensity aerobic ac+vity 30 min. 5x/week Muscle- Strengthening Ac+vi+es on 2 or more days / week all major muscle groups v Muscle- strengthening ac+vi+es on 2 or more days / week that work all major muscle groups AND Ø Muscle- strengthening ac+vi+es on two or more days / week that work all major muscle groups moderate- to vigorous- intensity physical ac+vity Break into 10 min. chunks! (Centers for Disease Control, 2008; Thompson, 2008) Odds & Ends I CANNOT AND SHOULD NOT BE CURED OF MY STRESS, BUT MERELY TAUGHT TO ENJOY IT Visual assessments Promote hydra+on Promote breaks Sleep Quality & Posi+on HANS SEYLE Image Source: hockeywriters.com ~Hans Selye 9

10 Objec+ves At the end of this session, par+cipants will be able to: 1. Iden+fy physical and psychosocial factors that contribute to musculoskeletal injuries in the workplace. 2. Conduct a personal worksta+on ergonomic assessment. Personalize Your Plan 3. Develop a personalized plan to prevent musculoskeletal injuries at work. References American Associa+on of Orthopedic Surgery. (2011). Chapter 1 Overview. The burden of musculoskeletal disease in the United States: Prevalence, societal and economic cost [Adobe Digital Edi+ons Version] (pp. 1-20). Retrieved from: hip:// American Ins+tute of Stress. (2009). Job stress. Retrieved January 15, 2009 from hip:// American Psychological Associa+on. (2009). Stress survey: Stress a major health problem in the U.S. Retrieved November 15, 2009 from hip://apahelpcenter.org/ar+cles/ar+cle.php?id=165 Centers for Disease Control and Preven+on. (2008). Physical ac+vity for everyone. Retrieved January 18, 2009 from hip:// Domanski, S.A., Gowan, N.J., Leyson, R.T., & Weller, M. (2008). Ergonomics in disability management. In K. Jacobs (Ed.), Ergonomics for therapists (3 rd ed.) (pp ). St.Louis, MO: Mosby Elsevier. Jacoby, S.M., Eichenbaum, M.D. & Osterman, A.L. (2011). Basic science of nerve compressions. In T.M. Skirven, A.L. Osterman, J.M. Fedorczyk, & P.C. Amadio (Eds.), Rehabilita>on of the hand and upper extremity (6 th ed./pp ). Philadelphia: Elsevier Mosby. Na+onal Ins+tutes of Health. (2007). X- Plain Managing Stress Reference Summary. The Pa+ent Educa+on Ins+tute, Inc. Retrieved November 10, 2009 from hip:// Maltchev, K. (2012). Preven+ng injuries in the workplace Ergonomics. In B. Braveman & J.J.Page (Eds.), Work: Promo>ng par>cipa>on & produc>vity through occupa>onal therapy (pp ).Philadelphia: F.A. Davis Company. Na+onal Ins+tute of Health. (2008). Effect of regular exercise on vascular func+on and cardiovascular risk in a sedentary work force. Retrieved January 11, 2009 from hip://clinicaltrials.gov/ct2/show/nct

11 Na+onal Ins+tute of Health. (2008). Eye exercises and stretches. Division of Occupa+onal Health and Safety. Retrieved January 10, 2009 from hip://dohs.ors.od.nih.gov/ergo_computers.htm Na+onal Ins+tute of Occupa+onal Safety and Health. (2009). Work organiza+on and stress- related disorders. Retrieved January 17, 2009 from hip:// Occupa+onal Safety & Health Administra+on. (2014). Computer worksta+ons. United States Department of Labor. Retrieved from hips:// Thompson, J.L. (2008). Conference on mul+disciplinary approaches to nutri+onal problems Symposium on performance, exercise and health Exercise in improving health v. performance. Proceedings of the Nutri>on Society. Tveito, T.H., & Eriksen, H.R. (2008). Integrated health programme: A workplace randomized controlled trial. Journal of Advanced Nursing, 65(1), Seaward, B.L. (2006). Managing stress Principles and strategies for health and well- being. (5 th ed.). Boston, MA: Jones and Bartlei Publishers. Thank you! Anne M. Haskins, PhD, OTR/L University of North Dakota Department of Occupa+onal Therapy 11