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

(1)

Can Improvements in Basic

Movement Patterns Lower the

Cost of Workplace Injuries?

(2)

Demographics

Lots of Stress

Physically Active

(3)

3

(4)

Workers’ Compensation Cost Overview

Musculoskeletal Injuries (MSI’s)

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

1,608 MSI’s during last 10 years totaling $6M

(5)

5

50% of Total Costs are Preventable

$K

$100K

$200K

$300K

$400K

$500K

$600K

$700K

$800K

$900K

$1000K

FY '09

FY '10

FY '11

$757 $788

$1M

$426 54 $387 56 $691 77 Total Workers' Comp Costs

(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

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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

(8)

Participant Flow

Scoring of Assessment

Physical Labor

Screening

Low Risk

Moderate

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9

(10)

Is this a bad movement or have we

just become bad squatters?

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11

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What has been observed ?

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Injury Validity: Functional Movement Screening

Study Journal Population n Cut

point +LR (95% CI)

Kiesel et al.,

2007 NAJSPT Professional Football 46 ≤ 14 5.9 (2.0 - 18.4) O’Connor et

al., 2011 MSSE Basic Training Marines in 874 ≤ 14 ≥ 18

1.8 (1.3 - 2.7) 1.1 (0.9 – 1.4) Chorba et al.,

2009 NAJSPT College Fem. Athletes 38 ≤ 14 3.9 (0.9 - 5.1) Butler et al.,

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Marines FMS Score Association with Attrition

Cycle

FMS Score

Number

Attrition

%

Risk Ratio P-value

Injury

Attrition

FMS Score <14

57

12.3 _3.90

(1.60-9.49)

<0.01

FMS Score >14

381

3.1 Marines with FMS scores <14 had nearly four times the risk of

injury attrition when compared to Marines with scores >14.

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15

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Participant Flow

Scoring of Assessment

Physical Labor

Screening

> 14, Has no

asymmetries

Scores a

≤14

, a 1, or has a

+/- 2 asymmetry

“0” = Pain on any

clearing exam or

movement

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17

Firefighters ‘At Risk’ Who Completed

Intervention Improved

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19

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Greatest Movement Limitations Align with

Essential Functions of Job

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21

$K

$20K

$40K

$60K

$80K

$100K

$120K

$140K

$160K

$180K

$200K

*2000 - 2007 2008 - 2009 2009 - 2010 2010 - 2011 2011 - 2012

$3

$10

$89

$156

$34

$3

$189 $4

$83

$0

Fire Department Police Department

Program Impact

Clear Reduction in Number and Severity

of MSI’s In One Year

* FD: 318 MSI’s totaling $1M, average cost per MSI $3,145 PD: 251 MSI’s totaling $807K, average cost per MSI $3,215

(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,

(23)

Contact Information

Larry P. Cassella, Jr. MS Kinesiology Program Manager HealthFitness Phone: 919.380.4449 Fax: 919.319.4567 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 27705 Phone: 919.681.7225 Fax: 919.668.1957