Can Improvements in Basic Movement Patterns Lower the Cost of Workplace Injuries?

Transcription

1 Can Improvements in Basic Movement Patterns Lower the Cost of Workplace Injuries?

2 Demographics Physically Active Lots of Stress Trying to be Healthy Poor Nutritional Habits 2

3 The Challenge 3

4 Workers Compensation Cost Overview Musculoskeletal Injuries (MSI s) 1,608 MSI s during last 10 years totaling $6M Public Works (all divisions) 735 MSI s totaling $2.9M Police Department 258 MSI s totaling $1.4M Fire Department 338 MSI s totaling $1.1M 4

5 50% of Total Costs are Preventable $1000K $900K $800K $700K $600K $500K $400K $300K $200K $100K $K Total Workers' Comp Costs Musculoskeletal Injuries (MSI) Costs $757 $ $788 $ $1M FY '09 FY '10 FY '11 $

6 Gaining Leadership Support 1. Identify movement-based cost drivers 2. Solution must be based on sound science and a. easy to implement b. quickly identify movement limitations c. measurable d. provide instant feedback e. goal-orientated 3. Can be applied in the worksite or fitness environment 4. Identifies movement need creates customized treatment plan 6

7 Gaining Participant Support 1. Voluntary program 2. Never punitive 3. Short time to complete 4. Easy to improve 5. Simple goal of balanced flexibility and strength allowing participant to create realistic goals 7

8 Participant Flow Physical Labor Screening Scoring of Assessment Low Risk Moderate Risk High Risk 8

9 How do we treat other health care issues? 9

10 Is this a bad movement or have we just become bad squatters? 10

11 Screen for Fundamental Movement Ability 11

12 What has been observed? Overall Workers Comp Cost: Orange Co. Fire Service Provided by Mike Contreras, CSCS 12

13 Injury Validity: Functional Movement Screening Study Journal Population n Cut point +LR (95% CI) Kiesel et al., 2007 NAJSPT Professional Football ( ) O Connor et al., 2011 MSSE Marines in Basic Training ( ) 1.1 ( ) Chorba et al., 2009 NAJSPT College Fem. Athletes ( ) Butler et al., 2013 Work Firefighter trainees ( ) 13

14 Marines FMS Score Association with Attrition Cycle FMS Score Number Attrition % Risk Ratio P-value Injury Attrition FMS Score <14 FMS Score > ( ) <0.01 Marines with FMS scores <14 had nearly four times the risk of injury attrition when compared to Marines with scores >14. 14

15 Local impact / application 15

16 Participant Flow Physical Labor Screening Scoring of Assessment > 14, Has no asymmetries Scores a 14, a 1, or has a +/- 2 asymmetry 0 = Pain on any clearing exam or movement 16

17 Firefighters At Risk Who Completed Intervention Improved 17

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19 Movement Limitations across Patterns 19

20 Greatest Movement Limitations Align with Essential Functions of Job (FD T1 was January 2011) (PD T1 was January 2012) 20

21 Program Impact Clear Reduction in Number and Severity of MSI s In One Year Fire Department Police Department $200K $180K $160K $140K $120K $100K $80K $60K $40K $20K $K $3 $10 * $3 $189 $89 $4 $156 $83 $34 $ * FD: 318 MSI s totaling $1M, average cost per MSI $3,145 PD: 251 MSI s totaling $807K, average cost per MSI $3,215 21

22 How Would You Start an FMS Program? Create a detailed business plan Follow all HIPAA, ADA and other employment laws Get top-down leadership support Communicate effectively to employees, e.g., why is this important to me? How will this benefit me? Create a detailed tracking procedure Measure success, e.g., musculoskeletal injuries, severity of injuries, time away from work, etc. 22

23 Contact Information Larry P. Cassella, Jr. MS Kinesiology Program Manager HealthFitness Phone: Fax: Robert J. Butler, PT, Ph.D. Assistant Professor Division of Physical Therapy Department of Community Health and Family Medicine Associate Director Michael W. Krzyzewski Human Performance Lab FIFA F-MARC Center of Excellence Department of Orthopaedic Surgery Duke University Durham, NC Phone: Fax: