PT43 LEC - Industrial PT INDUSTRIAL REHABILITATION: ERGONOMICS

Industrial Rehabilitation History

- the treatment of people who have acquired a disability or ○ Bernardino Ramazzini
disease during the course of their work, with the aim of - Italian, born 1633
allowing them to return to work or to a new job (Collins - Father of Occupational Medicine
Dictionary) ○ Hippocrates
- 5th Century BC
Ergonomics
- suggested how a surgeon’s workplace need to be
- the science of fitting the workplace conditions and job
designed and tools should be arranged
demands to the capability of the worker
○ Frederick Winslow Taylor
- primary goal is to reduce the stress and eliminate injuries and
- 19th century
disorders associated with overuse, bad posture and repeated
- proposed the scientific method: finding optimum
activities
method in carrying out a task
Work Hardening/Work Conditioning ○ Frank and Lilian Gilbreth
- 4 to 8-week functional programs designed to meet the - developed “time motion study” improving efficiency by
specific job needs of the patient removing unnecessary steps and actions
- work conditioning sessions are 1-3 hours for 2-3 days per ○ 1914 (before WWI)
week - focus was on Human factors (aviators)
- work hardening sessions are 2-4 hours for 3-5 days per - then later on the focus shifted on the aircraft (design,
week; GOAL IS DAILY PERFORMANCE controls, shape, cockpit)
- Work Conditioning is usually 1 discipline ○ Henry Ford
- Work Hardening is multidisciplinary, including psychosocial - 1920
management - focused on efficiency of motion to decrease the cost of
Functional Capacity Evaluation making an automobile
- evaluation of a person’s capacity to perform work related to - no worker must stop to attach a wheel, bolt, screw, etc.
his/ her employment (Soer et al., 2008, as cited in AOTA.org) ○ 1940 (WWII)
- evaluates individual’s health status, body functions, - focused on human limitations and capabilities
structures, work demands and the ability to perform job - focused on complex machines and weaponry
demand SAFELY ○ Alphonse Chapanis
- 1943
ERGONOMICS - replaced confusing designs in airplane cockpits
The Basics of Ergonomics ○ After WWII
- Airforce summarized researches in 19 volumes of work
Ergonomics - muscle force required to perform manual tasks
- field of study involving application of knowledge about - compressive low back disc force when lifting
physiological, psychological and biomechanical capacities - cardiovascular response when performing heavy
and limitation of humans (Butterworth, 1974) labor
- “ergon” means work; “nomos” means principles or laws - perceived maximum load that can be carried,
- this information is applied to the planning, design, job tools, pushed or pulled
equipment and work environment to enhance safety and ○ Cold War
health - began in 1941
- “FITTING THE WORKPLACE TO THE WORKER” - research laboratories focused on human factors and
- primary goal is to prevent WMSDs (Work-related ergonomics
musculoskeletal disorders) by evaluating and controlling risk ○ Human Factors Society
factors - formed in the US in 1957
Risk Factors - professional organization for human factors and
⬞ awkward postures ergonomics practitioners, renamed Human Factors and
⬞ repetition Ergonomics Society in 1992, now with 4500 members
⬞ material handling and serves as the benchmark for internationally
⬞ force recognized designation in the practice of ergonomics
⬞ mechanical compression ○ Growth of Ergonomics
⬞ vibration - computer hardware in 1962
⬞ extremes of temperature - computer software in 1972
⬞ glare - nuclear power plants and weapons in 1980s
⬞ inadequate lighting - internet and automation in 1990s
⬞ duration of exposure - adaptive technology in 2000s
○ Currently
Two Major Branches of Ergonomics - exoskeletons are being used to perform tasks
○ Industrial Ergonomics/Occupational Biomechanics - human factors and ergonomics remain multidisciplinary
⬞ focuses on physical aspect of work and human professions (industrial engineers, industrial
capabilities psychologists, occupational medicine physicians,
⬞ force, posture, repetitions industrial hygienist, safety engineers, architects,
○ Human Factors occupational therapists, physical therapists, industrial
⬞ related to the psychological aspects of work hygienists, designers, safety engineers, general
⬞ mental loading/decision making engineering, insurance loss control specialists)
PT43 LEC - Industrial PT INDUSTRIAL REHABILITATION: ERGONOMICS

Main Goal of Ergonomics Posture

- prevent WORK RELATED MUSCULOSKELETAL DISORDERS Neutral Posture
(WMSDs) through application of principles to identify, - optimal body position to minimize stress; and
evaluate, and control physical workplace risk factors provide greatest control
- MSDs are a class of disorders involving damage to: - least tension on the nerves, tendons, muscles,
⬞ muscles joints, discs
⬞ tendons - muscles at their resting length
⬞ ligaments - neck, shoulders arms, relaxed
⬞ peripheral nerves - shoulders neutral not elevated, nor in
⬞ joints abd/add/flex/ext
⬞ cartilage (incl IV discs) - neck not tilted fwd/bwd; or rotated to L&R
⬞ bones - elbow by the sides
⬞ blood vessels - elbow open at an angle
- FA neutral with thumb up
Work-Related Musculoskeletal Disorders (WMSDs) - wrist neutral
- also called: - ears over the shoulders
⬞ Cumulative Trauma Disorders (CTDs) - shoulder over the hips
⬞ Repetitive Motion Trauma (RMT) - hips over knees
⬞ Occupational Overuse Syndrome - knees over ankles
- defined by OSHA (Occupational Safety and Health - spine at a slight S shape with lower back slightly concaved;
Association) as a disorder of the muscles, tendons, ligaments, no rotation or side bending
joints, cartilage, discs not caused by a slip, trip, fall, MVA or
other accidents Repetition
- Risk Factors: - doing same motion or group of motions over a period of time
⬞ decreased blood flow to the muscles, nerves, joints - different tasks may still use the same muscle group leading
⬞ tendon / sheath damage to overuse
⬞ muscle, tendon, ligament sprain / strain
⬞ joint damage Force
⬞ personal risk factors: physical condition; health - amount of physical effort required to accomplish a task
problems, age, gender, work techniques, hobbies, - higher force usually placed upon muscles, tendons and joints
previous injuries, smoking, quotas, fatigue, etc. (OSHA)
- Examples: - prolonged exposure results to fatigue, overuse, strain, sprain,
⬞ Epicondylitis leading to damage
⬞ Tendinitis
⬞ De Quervain’s (tenosynovitis of the thumb) Compression
⬞ Trigger finger - concentrated force in small area
⬞ Reynaud’s syndrome (vibration white finger) - can reduce blood flow or tissue irritation
⬞ Carpal tunnel syndrome - MOST COMMON: sharp or hard desk creating compression
⬞ Back strain on FA or elbow – neuropraxia to the nerves of the FA
- the following are often associated with WMSDs:
⬞ Postures Vibration
- awkward, static, prolonged Single Point Vibration
⬞ Forces/Compression - common with tool use with UE
- Forces: heavy, frequent, awkward - decreased blood volume to the extremities
lifting; prolonged loads - can cause vascular spasms, constriction of blood vessels in
- Compression: gripping; FA pressure fingers
during computer work (refer to
computer worker on left) Whole Body Vibration
⬞ Repetition - usually found in vehicles (forklifts, cranes, trucks, mowers,
- Assembly Line: doing the same thing buses, ocean vessels, aircrafts)
for the entire day - usually affects the spine
⬞ Vibration - can contribute to chronic LBP
- hand arm vibration or whole body
vibration
PT43 LEC - Industrial PT INDUSTRIAL REHABILITATION: ERGONOMICS

Other Risk Factors

○ Duration and Magnitude
- continuous exposure does not allow sufficient recovery
time
○ Temperature Extremes
- cold environment places greater aerobic demand to the
worker; resulting to faster fatigue; reduces dexterity
causing the need to grip harder, causing compression
and decreased blood flow; cold temperature also
constrict the vessels
- hot / warm temperature exposure causes workers to
move slowly, making the task longer, i.e. use of PPE
decrease evaporation from skin reducing the body’s
ability to cool itself
○ Inadequate Recovery
- no time for stretching, alternating tasks, micro breaks to
allow for recovery time

Other Personal Risk Factors

⬞ Age
⬞ Gender
⬞ Hobbies
⬞ Smoking
⬞ Obesity
⬞ Previous Injury
⬞ Medications
⬞ Fatigue
⬞ Poor Physical Conditions

Common Signs and Symptoms to look for:

⬞ Painful aching joints, muscles; pain and discomfort Pain,
tingling, numbness
⬞ Shooting or stabbing pains
⬞ Swelling or inflammation
⬞ Warmth
⬞ Stiffness or difficulty moving Burning sensation
⬞ Pain at night
⬞ Loss of strength and mobility
NOTE: Early identification may reduce the risk and severity of injury.