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Viewing 15 posts - 31 through 45 (of 45 total)
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  • in reply to: “as tolerated” work restrictions #38315

    JB
    Participant

    Jeff,

    The best approach I have to ethically provide information about a client’s tolerances are to perform a 2-day Functional abilities evaluation to gain “snap-shot” tolerances towards specific postures, positioning, or tasks. Provision of two days of test and retest information can provide an employer, case manager etc with “usable” information to better recommend safety parameters (if needed) for a return to work process or as part of potential permanent limitations. This assessment can also provide the client with an opportunity to express their reservations about certain tasks and therefore the evaluator an opportunity to educate (briefly) about proper mechanics and implementation of relative rest breaks etc.

    Many FAE protocols provide tools to assess essential functions, however it is important to take into consideration all variables which contribute to a clients functioning as well….i.e how they think and feel about activities.

    Unfortunately, I don’t think there is a cookie-cutter approach to safeguards. Early assessment of function with a variety of standardized approaches seem to be the most effective way of determining “thresholds”.

    Hope this helps

    in reply to: definitions for ‘prolonged’ and ‘sustained’ #38208

    JB
    Participant

    Prolonged or Sustained work as it relates to Static Muscle Work can be defined as follows:

    -Operationally defined as forces applied for 20 sec or longer, continuous forces should not exceed 5% of maximum capacity

    The following factors also need to be considered:

    -Dependent on limb and muscle size

    -Physiological Risk factor

    -Work to Recovery

    I have been informed (from a reputable company in and around the Toronto region) that the Ontario Ministry of Labour accepts anything greater than 10 seconds for the upper extremities and 20 seconds for the lower extremities to be “prolonged”……although, I have yet to see this in any research….yet. As force becomes a factor, so does the ability to sustain static postures. The following resources have more information regarding work to recovery

    Rogers & Romar

    U of M Static Strength pgm

    My opinion of “prolonged or sustained” is that we can control these elements in most instances by incorporating relative rest breaks. This “control” however, comes at a price……….becoming more conscious of our working postures throughout the day to acknowledge when we are placed or exposing ourselves to prolonged or sustained postures, and then interrupting these postures momentarily with relative rest breaks. Sounds easy…but a difficulty behavioural change.

    in reply to: Mouse Clicks #38162

    JB
    Participant

    Ben

    BINGO! hence the need to educate “data entry” employees about the importance of relative rest breaks and reducing prolonged/repetitive typing. Educating employees to become more PRO-ACTIVE with regards to controlling force, repetition/duration, and position is vital towards improving overall employee health and well-being.

    The info provided in my previous post was part of a “checklist” when assessing Fingers/keystrokes and was taken from ANSI. The other factors to consider are one versus two hands, total task duration, and force. Overall, I would recommend any interruption, whether it is 5 seconds or 5 minutes, is important to implement on a 10-15 minute sustained keyboarding activity to promote “re-cuing” of neutral postures or changing postures altogether by implementing a mini-break (quick stretch session).

    Difficult concept to implement for the average employee who has deadlines etc to deal with on a hourly/seemingly minute basis.

    in reply to: laptops and home offices #38161

    JB
    Participant

    Laptops….designed for portability not prolonged use. I agree with “DaveMac” to set up a home office with docking station. The most useful article (Ankrum and Associates) indicating most recent evidence based guidelines is attached. I encourage everyone to read it. Please continue to provide links to newer articles either agreeing or disagreeing with the guidelines.

    Thanks in advance

    in reply to: Workbench for charting in medical record #38160

    JB
    Participant

    It appears we need some guidelines here. The following guidelines are taken from Applied Ergonimics, 1995 Humantech, p 108

    A. Height – work should be adjustable between 29-50″

    for: Precision work 40-50″

    Light work 35-45″

    Heavier work 29-39″

    B. Work surface andle (adjustable as required) -6 to 30 degrees

    C. Rounded edges on surfaces that contact operator

    D. Foot clearance 4″ deep, 6″ high

    E. Platforms 3″ increments

    in reply to: Hook-n-loop closures and hand force #38119

    JB
    Participant

    Reading your post made me think of factors such as employee satisfaction (rate of pay) volume of customers and wrist mechanics/working postures.

    Removing velcro straps could drive one mad if performed frequently ALL DAY (I would think). Ensuring sales staff are utilising a “Palmar Pinch” (thumb and first two fingers) or “Key Pinch” with preference towards the Key Pinch could enable sales staff to perform this task in a more functional manner than the traditional “Tip Pinch” (thumb and first finger). One can exert most force with the KEY and PALMAR pinch position when compared to a TIP pinch.

    With little people, I’m guessing staff are adopting low level positions. Also ensuring they are practicing one point kneel or using a portable stool etc to facilitate the fitting also pops up as a red flag. Overall, shoes which are made for little feet should not have straps that would exceed little hands’ abilities to get in and out of them…….one would think anyways.

    I’ll do a search and get back to you with some threshold values if any…..the info you actually requested :)

    in reply to: Increasing lifting demands on Medical Examiners #38074

    JB
    Participant

    BHM Medical products carry an interesting array of fixed ceiling track and portable lifting devices specifically for hospital or attendant care facilities. Chek it out

    in reply to: Return to Work Criteria #38036

    JB
    Participant

    I have put some more thought into your original question and have discussed this topic over a few glasses of red wine with a buddy of mine who happens to be molding young minds to become OPP officers. The following are current physical fitness tests that the RCMP and Correctional officers use to determine whether an employee is capable of performing the strength/maneuvering abilities for their positions.

    Hope this helps

    Please see attachments

    in reply to: posterior tibial injury and ankle pain #38033

    JB
    Participant

    Working alongside some great physiotherapists who have advanced manual training techniques (Part A and B) we have found that the cuboid, a bone in the foot, can sometimes become subluxed, resulting in excessive strain to the tib posterio’s mechanical load. Assessment, to determine if this is the case, by a qualified manual trained physio may help to solve the biomechanical riddle of the foot.

    I’m a big fan of proprioception exercises (balance) in closed chain. Use of the “fitter” slide board and BOSU ball are good unstable bases of support to aid in the retraining of ankle, knee, hip, spinal stabilizers.

    As a “part time runner” myself, I have found that many athletes put low value on a proper warm up and want to run “at pace” as soon as possible. Ensuring a gradual return to sport is essential to ensure this condition does not become a chronic pain in the errrr ankle.

    Good luck

    in reply to: Mouse Clicks #38017

    JB
    Participant

    Looking for specific studies, however in meantime…….The ANSI checklist indicates the following thresholds for finger “key strokes”

    Repetition rate (# motions) = less than 15000 in one hour indicating that if the data inputting exceeds this number, “studies” have indicated that this could lead to musculo-skeltal injuries

    in reply to: stretch break reminder software #37779

    JB
    Participant

    Stretch software is a great “quick fix” to a more complicated issue. I forsee an individual working on a crucial part of a report and then……..*bing* they are directed to a website to perform stretches, hence losing their train of thought and generating some angst towards a method designed to “de-stress” associated muscle tension created from sustained postures, when in fact, the reaction of the employee in this hypothetical situation could serve to generate a greater stress response called………anger!

    The word for the day is “mindfullness”. Employees could benefit much greater from increasing their mindfullness while at work. Using this software much like a timer, rather than a disrupter could serve to increase the employee’s mindfullness of their duration of sustained seated postures. Through education about why and how to perform mini-breaks/relative rest breaks could be an opportunity for the Occ Health Nurse, HR or whomever would be implementing education sessions, to hold an inservice about the importance of a change of position in this everchanging workforce. Employees could then voice their opinion about the reality of taking a break….i.e. is their a feeling from the staff that this is discouraged……do they feel overworked and underappreciated. This session could be the tip of the iceberg to bring forth some topics of discussion to assist with the HR etc dept to actively involve their staff in an effort to more fully “engage” them in their work.

    In my opinion, I believe encouraging an active lifestyle and improving endurance of spinal stabilizing musculature would far outweigh the benefits of implementing a software application that may just add to our daily troubleshooting measures……my two cents

    in reply to: Work while Snowboarding #38016

    JB
    Participant

    WORD!!!! I’m in full agreement with “Vedder”…..becoming more “mindful” of our FREE TIME is essential to encourage our psyche to recharge it’s positive energy tanks. Time to eat some more granola with Soy milk.

    in reply to: Libraries and DVD / VCR cases #41450

    JB
    Participant

    The clothing industry comes to mind as I read the above posts. Next time you visit an Old Navy etc, check to see how they remove the security tags from the merchandise. Now if someone could only develop a scratch proof CD/DVD product……….

    in reply to: Return to Work Criteria #41405

    JB
    Participant

    I’d agree with Trudy in that attempting to assess a non-cyclical position with forces that may vary to extremes is difficult to assess, however, the ability to objectively determine average or threshold values can still be determined by implementing a pilot study with your local police force. Once you determine ALL forces, positional requirements and potential frequencies, you would have at least SOME information to base an opinion as to whether an individual could participate in a graduated return to work plan.

    Checking fitness standards for new police recruits could be a short term set of criteria until you or others better quantify these unusual maximal forces. This sounds like a good thesis topic………..hmmmmmmmmmm, maybe Grad school is in the near future.

    in reply to: Return to Work Criteria #41378

    JB
    Participant

    RE: objective criteria for RTW of Law officers

    As part of an independant medical assessment team for the greater Kingston area I would recommend a physical demands analysis be performed to identify some of the push/pull forces that may surface during such an encounter. A pilot project with your local law enforcement chapter could begin to “objectify” the physical forces identified during such a restraint.

    It is also important to ensure that the client is cleared from a spinal stability perspective. Assessment following the Australian Spinal Stabilization Method may be something to include in your protocol.

    Good Luck

Viewing 15 posts - 31 through 45 (of 45 total)
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