The implementation of motor learning principles in designing prevention programs at work

Occupational therapy practitioners offer services to workers in the workplace to prevent musculoskeletal disorders (MSDs), to help the injured worker restore function, and to recover capacities needed to return to the job. Despite the existence of some evidence about the efficacy of prevention programs, there is uncertainty and even disagreement among health professionals, about the outcome of prevention programs for people with MSDs. It is proposed that principles of motor learning can assist the therapist in structuring prevention programs to facilitate the workers learning of correct movement patterns. This paper discusses basic concepts of motor learning emphasizing characteristics of the learner, the type of task, the structure of practice and application to prevention programs at work settings. We present a four-stage model for prevention programs based on principles of both motor learning and ergonomics. This model coincides with the broad perspective suggested in current occupational therapy models which focuses on the person, the environment, the occupation and their effects on occupational performance.     

Musculoskeletal symptoms among dentists in relation to work posture

OBJECTIVE: To determine the effect of work posture on musculosketal complaints in Israeli dentists. METHODS: The population included 60 male dentists mean age was 46.0 (+/- SD 8.66), 30 worked in sitting position and 30 were altering positions. Study population completed the standardized Nordic questionnaire and informative form concerning recipient's practice of dentistry, bio-demographic variables and questions about workloads. RESULTS: Musculoskeletal symptoms in the last 12 months were localized primarily in the lower back and in the neck (55% and 38.3% respectively). There was a significant correlation between the time spent sitting and the severity of low back pain (r = 0.41, p = 0.01). On the other hand there was no significant correlation between time spent sitting and other musculoskeletal complaints (r = - 0.16). CONCLUSIONS: Dentists who work in the sitting position have more severe low back pain than do those who alternate between sitting and standing despite the fact that those who sat at least 80% of the time worked less hours and had less of a workload during their working hours. This suggests that altering position should be recommended to dentists. An intervention study, however, is needed to demonstrate that changing posture will decrease the prevalence of low back pain in dentists.     

Functional capacity evaluations as a post-offer employment: a case study

Functional capacity evaluations in the post-offer phase of employment has the capacity to minimize work related injuries and promote wellness on the worksite. This paper includes a discussion of the value of post-offer evaluations and possible assessment options. To investigate the feasibility of administering post-offer evaluations, a case study was initiated. The Physical Work Performance Evaluation (PWPE) was administered to a new employee, VA, who was employed for the task of kneading dough, at a major food company. When compared to detailed work demands, there was no match between the job demands, and the client's capability in two sub-tests: lift from waist to eye level and trunk rotation. Based upon findings, recommendations for an initial graded work schedule, basic strengthening exercises, and modifications of the job site and task were made to the employer. The project was initiated with the hope of raising employee's and employer's awareness of workers health issues in the post-offer phase as it express itself in post-offer evaluation that aims to prevent musculoskeletal problems. This article aims to expand occupational therapists' awareness to the potential benefits of such a process.     

Multi dimensional system for evaluating preventive program for upper extremity disorders among computer operators

Typing is associated with musculoskeletal complaints (MSCs), caused by multiple risk factors. Although a wide variety of ergonomic intervention programs were conducted to reduce risk factors and MSC's, only few of them were found evidence based. This study aimed to test the efficacy of a workplace intervention in reducing MSC's among computer workers. 66 computer workers were assigned randomly to one of three intervention programs: ergonomic intervention including biofeedback, intervention without biofeedback and control group without intervention. The efficacy was tested by advanced assessment including; pain location and severity, posture at work, upper extremity 3D kinematics, muscle activity and psychosocial status. Working hypothesis; significant score differences will be found between the study groups which underwent ergonomic intervention and the control group on the following measures: pain complaints, upper extremity kinematics, muscle activity and psychosocial status. Significant differences were found between pre and post intervention and between research groups and the control group in pain, posture and motion. The ergonomic intervention with biofeedback had no unique contribution in comparison to other interventions. In conclusion; the proposed intervention program was found efficient for reducing pain among computer workers.     

Part II: the effect of long-term exposure to organic solvents on senso-motor skills: a cross sectional study

A heterogeneous population, with cultural and linguistic differences, could benefit from nonverbal assessment. This was the case with this research population, and in this constellation we felt that for continuity to cognitive evaluation of industrial painters we had to add at least two tests limited mainly to senso-motor aspects of human behavior. Moreover, this practical strategy decreased workers' tension regarding testing circumstances and yielded fewer possibilities for compensating an impaired function by use of other, unaffected ones. Reaction Time and Finger Tapping were the tests we chose because of their well-circumscribed elemental functional sensitivity to neurotoxic exposures. The research design was cross-sectional. Study population included 31 industrial painters who were exposed at work to organic solvents and 31 unexposed workers. Workers after long term exposure to organic solvents showed significantly higher response rate and decline in Finger Tapping scores in comparison to unexposed workers. The results showed a significant negative correlation between exposure index and number of finger tapping with dominant hand, non dominant hand and altering with both hands indicating that the higher the exposure index was the lower the number of finger tapping. It was also found that the affect of age on Reaction Time and Finger Tapping of dominant hand was significant among workers after long term exposure to organic solvents, whereas for the unexposed workers those basic functions were unaffected.