| Loss Control TIPS A Technical Information Paper Series Brought to You by the Hartford Innovative Safety and Health Solutions Warming Up to On-the-Job Exercise: | ||||||||||||||||||||||||
Introduction It has been suggested that exercise can be an effective part of an ergonomic program designed to address work-related musculoskeletal disorders (WRMSDs). Benefits of exercise as part of a more comprehensive health and safety program have been identified in the literature within the field. However, the effectiveness of on-the-job exercise programs in and of themselves has not been conclusively established. Research results vary as a reflection of differences in research criteria, including study designs, methodologies, populations, design of exercise programs (exercises performed, frequency, duration, etc.), and outcome measures. Some examples are illustrated in the following summaries. Literature Review Silverstein et al. evaluated the effectiveness of an on-the-job exercise program in 1) reducing the severity of existing musculoskeletal symptoms of discomfort and 2) preventing future occurrences among active workers in a health product plant. An exercise program was designed by a physical therapist with the objective of controlling musculoskeletal symptoms in the neck and upper limbs. Employees performed the exercises of seven minutes, two times per shift, along with accompanying music, in the manufacturing area. Exercise was specifically isolated from other job changes or treatments to evaluate the effectiveness of exercise. There were no statistically significant differences in localized postural discomfort scores or in the proportion of those whose discomfort decreased based on exercise participation. Although no clear reduction in discomfort was achieved by the exercise program alone, at least 67% of respondents who participated in the exercise program reported that the program made them feel better Kohler presents a literature review and reports benefits of preventive stretching programs. At one company, such a program reduced reported carpal tunnel syndrome cases from 11 (in a nine-month period) to one (in two years). Adoption of preventive stretching exercises resulted in injury reductions for five companies ranging from 56 percent to 91 percent. A regime of exercises performed for seven minutes two times a day brought about a 62 percent decrease in medical department visits for musculoskeletal injury related disorders. Allers reviews the benefits of a pre-work flexibility stretching program and finds such a program to be effective in reducing medical costs by reducing the incidence of injuries. The specific experiences of several companies are cited. Manzo et al. illustrate the effectiveness of corporate exercise programs in reducing or eliminating risk factors that can lead to workplace musculoskeletal disorders (WMSDs) in manufacturing operations. There were fewer reported overexertion injuries among the group who participated in a worksite program that consisted of 6-minute stretching exercises of the wrist, shoulder, neck, and back. In addition, workers who participated in a lumbar strengthening program gained significantly more strength and lost less time from work. Laporte compared 10-minute "gymnastic pauses" to 10-minute rest periods among post office workers and found reduced fatigue in both groups and significantly reduced visual fatigue among the gymnastic pause group. Cox et al. were able to demonstrate improvement in overall fitness and absenteeism after six months of an employee fitness program implemented in an insurance company, including improvement for those who did not participate in the fitness program. Hansford et al. found improved blood flow to the wrist among suture winders after five minutes of rest from work, and more improvement with stretching, isometric, and light dynamic wrist exercises. Lutz and Hansford (among suture winders) and Sawyer (among racquet manufacturing employees) reported reductions in hand/wrist disorders such as carpal tunnel syndrome with the introduction of on-the-job exercise programs. Both programs included job redesign as well as more aggressive medical management. Seradge suggests that exercises decrease the pressure on the median nerve. He recommends five-minutes of exercise at the beginning of work shifts and at breaks for workers with hand-intensive jobs. He states that daily exercise, combined with job modification, will save employers money that would otherwise be spent on medical care. Battjes studied the effects of a 12-week preventive/corrective stability training program on self-reported symptoms of cumulative trauma in female computer operators. The intervention consisted of a 30-minute exercise program performed three times per week. Results indicated that the specific types of exercises employed in this program decreased self-reported symptoms of cumulative trauma in the participants as compared to a control group. Thomas et al. studied the effects of participation in an exercise program in increasing upper extremity flexibility, strength, and circulation on symptoms of carpal tunnel syndrome. The exercise group participated in daily upper-extremity exercises for eight weeks. Test results indicated no statistically significant differences in nerve conduction latency or subjective comfort between the two groups. Significant difference did develop in grip strengths over time, suggesting that the exercise group may have benefited physiologically from the exercise program. Overall, the findings of this research are generally favorable, demonstrating no negative effects on individuals or job performance. In fact, some studies have demonstrated improvement in criteria like productivity and individual comfort as a result of participation in an exercise program, particularly when the exercise program is an integral part of a comprehensive and coordinated occupational health and safety program. The literature supports integration of occupational health and safety programs, which have traditionally maintained a work-related focus, with health promotion and/or wellness programs that address work and non-work-related health problems. How Do Exercise Programs Work? WRMSDs are associated with risk factors in the work environment and personal characteristics. Risk factors in the work environment include static and/or awkward postures, forceful exertion, and repetitive motions. Individual risk factors include poor nutrition, obesity, and substance abuse (nicotine, alcohol, drugs). The likelihood of an employee developing physical discomfort can be reduced by maintaining a healthy life style, working at a well-adjusted workstation, alternating tasks, and exercising. In addition, exercise may be a useful preventive measure and an effective tool after an injury has occurred, or when a recovering employee returns to work. Exercise appears to accomplish the following:
Types Of Exercise Programs There are many different types of exercise programs. Warm-ups are designed to limber up muscles before performing strenuous work, much as an athlete would do. Regular stretch breaks are intended to periodically stretch unused muscles and to provide relief from being in the same position for too long. Conditioning exercises get people in shape by strengthening muscles and improving flexibility and endurance. Suggestions for Designing An Effective Exercise Program
Incorporate these guidelines into the exercise program:
Summary There are a variety of reasons why employers should consider providing exercise, including overall employee wellness and morale. Improved wellness and morale can contribute to cost savings from lower health care premiums, decreased absenteeism, and increased productivity. Well-designed exercise programs can serve as part of a comprehensive musculoskeletal disorder prevention program. While the effectiveness of exercise programs in the prevention of work-related musculoskeletal disorders has not been proven definitively, the benefits of exercise have been demonstrated in many situations. While many ask "Does exercise help prevent work-related musculoskeletal disorders?" the real question is "Which types of exercise will help prevent what types of musculoskeletal disorder and under what conditions?" Key issues which will influence the success of the program include the design of the program, employee attitudes, and the level of employee participation. The exercise program itself must be appropriate to the job tasks and environment, and the specific exercises must be selected carefully. Avoid exercises that must add to postural discomfort. As necessary, request the assistance of qualified professionals in the development of the exercise program. Occupational therapists, physical therapists, exercise physiologists, ergonomists, or other healthcare professionals who are knowledgeable about WRMSDs and who are experienced in work programs would be capable of providing such assistance. As with other safety and wellness programs, an approach that places primary responsibility on the employee and emphasizes proper behavior and self-care techniques will be most effective. Developing an employee exercise program is a proactive way to reduce workplace injuries; however, it can't prevent them all. That's why you should be prepared with solid liability protection from an experienced provider. The AICPA Commercial Property and Liability Program can provide added protection against unforeseen risks. For more information and serious protection, get your free, online quote today. In a short period of time, we'll match you up with a provider who is best-suited to meet your unique insurance needs! References
For more information, contact your local Hartford agent or your Hartford Loss Control Consultant. Visit The Hartford's Loss Control web site at http://www.thehartford.com/corporate/losscontrol/. This document is provided for information purposes only. It is not intended to be a substitute for individual legal counsel or advice on issues discussed within. Readers seeking resolution of specific legal issues or business concerns related to the captioned topic should consult their attorney and/or insurance representatives |
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