By Virginia Halling, PT
This article highlights the specialized skill set that rehabilitation professionals bring to ergonomic initiatives, and suggests methods to interact effectively with employers and their unique set of safety professionals, engineers, and ergonomists.
Wojciech Jastrzebowski, a Polish scientist, professor, and philosopher, is credited with creating both the term and the concepts of ergonomics in 1857, during the first industrial revolution. He fundamentally recognized that if work was less burdensome, productivity would be better and both companies and workers would ultimately be more profitable.
In the latter half of the second industrial revolution, as production lines entered the picture, ergonomics was part of the scientific approach to mass production and manufacturing as it spread. Methods that improved work efficiency were highly sought-after.
World War II saw a shift of focus to the interface between man and machine as research revealed aircraft design was flawed and was subsequently improved to reduce plane crashes. The study of the abilities and limitations of the human condition as it interfaces with the work environment was under way.
The following companies offer products and services that can be helpful for workplace ergonomics, industrial rehabilitation, and work injury assessment:
DSI Work Solutions Inc
WorkWell Prevention & Care
Ergonomics is an applied science that encompasses a broad spectrum of approaches that include behavioral psychology, human physiology, and engineering to enhance work processes that improve productivity, reduce error, and prevent injury. Ergonomic initiatives should not be at the expense of productivity and quality.
Ergonomic services are provided by a number of professionals (and quasi-professionals) with varying backgrounds and approaches. Each brings his or her own unique skills and perspectives to the challenge of supporting and advancing productivity and quality initiatives as well as eliminating work-related injuries.
Worksite International’s Allison Heller-Ono, MSPT, CIE, CPE, provides a helpful summary of today’s ergonomic service providers. The highest level is considered to be ergonomists who achieve national/international certification—the most rigorous level of qualification. Those ergonomists are designated as such by the Board of Certification in Professional Ergonomics (BCPE) or the Oxford Research Institute (ORI). The BCPE designates certification as Certified Professional Ergonomist (CPE) or Associate Ergonomics Professional (AEP). ORI designates certification as Certified Industrial Ergonomist (CIE) or Certified Associate Ergonomist (CAE).
Other ergonomists commonly complete advanced training through private credentialing firms. Options are numerous. Individual professionals commonly receiving credentialing in this manner include physical and occupational therapists, chiropractors, athletic trainers, safety professionals, occupational health nurses, loss control agents, ergonomics products sales staff and others.1 Some employers have their own internal ergonomic training and credentialing processes, and some are industry-specific.
Rehab Professionals in Employer Settings: Beyond Treatment
Licensed rehab professionals apply their knowledge of human function, anatomy, physiology, pathology, mechanism of injury, and biopsychosocial factors to assessing a patient’s needs in order to develop and/or deliver a plan of care. It can be said that when a rehab professional examines workers performing a job, it is a similar process. As workers are observed and job demands are measured, rehab professionals can readily identify which areas of the workers’ bodies are stressed in ways that correlate with certain mechanisms of injury. One scenario could be correlating back pain complaints with a particular work activity (a potential mechanism of injury).
It is not difficult for the rehab professional to identify likely contributors. What needs to be addressed in a particular work activity can be communicated to the employer. When this communication is backed up with objective data from a job analysis—including postures, body mechanics, forces, heights and distances, for example, employers can often intercede with their own resources to make improvements. This approach can be used in a number of scenarios. One is to guide a worker back to their job safely after injury or illness. Another is to intervene when a worker has a concern not yet requiring medical intervention.
Of particular importance to employers is preventing injury altogether. For example, if an individual worker has had a back injury, or an individual worker has a concern about his back being sore, or a job has been identified that back stressors are of concern, the rehab professional often readily recognizes the movements, positions, and forces that are likely contributing factors. It is often not difficult to “see” what needs to change and provide the employer with feedback leading to positive change. When a formal job analysis is performed, an objective measurement of forces, movements, and positions is documented and substantiates the rehab professional’s recommendations. This skill in and of itself is a powerful tool to aid employers in better matching the worker(s) to the job, often with minor (definition: low cost/easy to implement) changes that provide substantial results.
Working with Employers
Each employer approaches ergonomics differently. In some instances, the safety professional is responsible for spearheading injury-prevention strategies and may even train and lead in-house ergonomic teams. Another may place that responsibility with engineers. Yet another may employ or contract with ergonomists. The rehab professional as such can play a contributing role in any of these scenarios. However, it is often critical that ergonomic interventions be justified—using the ergonomic tools and measures that are common in the industry today.
Rehab professionals can lead with their own specialized skill set and enhance those skills with advanced learning in ergonomics. It is important that those existing skills and the level of ergonomics background are well-communicated to the employer. The rehab professional can be most effective in this manner and can coordinate with the employers or other professionals on ergonomic initiatives. Sometimes the rehab professional’s unique existing skill set is adequate; at other times it makes the most sense to coordinate with the skill set of others to produce even more powerful results.
Advanced Learning in Ergonomics
The options today are numerous and varied. They range from independent learning to short courses to in-depth study. Cindy Lawton, PT, CPE, a seasoned professional working as a part of a team of advanced ergonomists, suggests that rehab professionals have a working knowledge in the following areas to best serve employers and their in house safety professionals and engineers: anthropometrics, screening tools that define risk (see Table 1), office ergonomics, material handling equipment, personal protective equipment, aging factors and return on investment strategies.
Kim Smith, PT, DPT, owner of Onsite Work Solutions in Morganton, NC, practices exclusively in the workplace, and ergonomics is an essential part of her service line. “I found that identifying ergonomic challenges was important, but that quantifying risk was essential to allow employers to prioritize projects. For that reason, when identifying ergonomic risks during job analysis, we objectively assess risk as much as we are able to in order to assist employers with prioritizing ergonomic projects.
“Ergo tools we routinely use are RULA, REBA and the NIOSH lifting equation. The lifting equation is used to determine recommended weight limits (RWL). Often, Liberty Mutual Material Handling Tables (Snook Tables) are used to assess physical task acceptability for a defined percentage of the population. In addition to these assessment tools, we also consider the frequency of risk exposure as well as the severity of potential injury when ranking identified ergonomic risks for our clients. Quantifying risk is extremely useful to our clients. Providing objective measurements of risk and determining employee exposure to identified ergonomic risks is essential to be able to do that.”
Rehab professionals are increasingly a part of the fabric of injury management, injury prevention, and ergonomic initiatives in today’s workplace. It is important to recognize and raise awareness relating to the unique skill set that the rehab professional brings to the table. When combined with current ergonomic principles and thinking, rehab professionals can and indeed are making a significant impact. These services offer a viable income stream for today’s rehabilitation practices and practitioners, and have a substantially positive impact for the employers and employees served. PTP
Virginia “Ginnie” Halling, PT, is chief executive officer of DSI Work Solutions. For more information, contact PTPEditor@medqor.com.
1. Worksite International. 7 Common Ergonomics Certifications and What They Really Mean. Available at: https://www.worksiteinternational.com/blog/7-most-common-ergonomics-certifications. Accessed August 23, 2019.