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APS Presentation 12:45 p.m. EDT, Sunday, April 29
Pressroom presentation 11 a.m. EDT, Sunday, April 29
Embargoed to the date and time above
Media Contact
Sarah Goodwin
(202) 249-4165 April
28-May 2
Free Weight Training Gets Workers With Rotator Cuff
Injuries Back On The Job, Happy, After Surgery, Traditional Rehab Fails
Resistance training, some of it job-specific, was successful in getting
90 percent of workers with severe rotator cuff injuries back to work, the
majority (75 percent) at their previous job, after traditional physical
therapy had failed to do so. Furthermore, all but one of the 42 employees in
the study (98 percent) reported satisfaction with the resistance-training
program and its outcome.
Dr. Jamie Stark described this and five related studies of workers
suffering work-related rotator cuff and lumbar fusion injuries at
Experimental Biology 2007, meeting in Washington, DC. His presentations, on
April 29, are part of the scientific program of The American Physiological
Society.
Participants in the rotator cuff study represent a class of
“worse-case-scenarios” of work-related injuries. Rotator cuff injuries
involve those muscles and tendons that stabilize the shoulder and can be
caused by pulling the arm out of place, by falls and other accidents. All
42 of the employees had been through surgery to repair their torn muscles or
ligaments. All had already gone through weeks of traditional rehabilitation
and physical therapy. Even so, none had been judged capable of going back to
work and thus were eligible for disability and workmen’s compensation
settlements.
This was just the patient population Dr. Stark, director of Research and
Development at the Athletic and Therapeutic Institute in Chicago and his
colleagues at the research division of the Institute wanted. Nothing had
worked for these patients, and the researchers figured that what would
work for them also would work for employees with less severe injuries.
The injured employees attended the Institute program four hours a day,
five days a week, on average for six weeks. Their daily training began with
warm up, stretching, and core exercises for balance and proper biomechanics,
then moved to free weight resistance training of the upper and lower body.
Unlike traditional physical therapy programs after injuries, this program
was a modified version of what professional and collegiate athletes do using
free weights. On the third day of the week, the exercises involved less
weight than the previous two days but were much more dynamic, addressing
specific injury and biomechanical patterns related to the workers’ previous
jobs. A drywaller, for example, would work muscles used in lifting large
sheets of drywall overhead and in place. During the last two days of each
week, the amount of weight used during free weight lifting was heavier than
that of the first two days of the week.
At the end of the six weeks training, the workers were tested on physical
function (a four hour protocol based on U.S. Department of Labor
classifications of different types of work, re specific amounts of weight
lifted for specific percentages of time). Ninety-six percent of patients met
or exceeded the physical function levels of their previous job, and 90
percent went back to work, most at their previous job. Almost all employees
were satisfied with the program, and so were employers.
Dr. Stark says, “We are at a new era in which we can develop standardized
exercise prescriptions that produce desired, achievable functional goals.”
He believes doing that will meet the goals of all key stakeholders. Patients
want to regain full function as soon as possible and be satisfied with their
physical and work outcomes. Employers want workers to come back to work as
soon as possible, as fully as possible, at a cost that prevents escalation
in insurance premiums.
And payors, whether insurance companies or self-insured employers, are
interested in the cost benefit between getting a worker back to the job at a
functioning level (costs of medical, physical therapy, and other
rehabilitation programs such as those these workers went through) and a
worker’s not being able to go back to work at all or at his or her previous
level (costs of long-term disability settlement, workman’s compensation).
“To date,” says Dr. Stark, “this model of rehabilitation using intense free
weight training has proved objective, measurable, and successful in patient
satisfaction, return to work, and cost benefit.”
The researchers now hope to test the model in a larger prospective trial
of workers at varying levels of injury in order to demonstrate increased
outcome efficacy with a standardized prescription and concurrently measure
cost-benefit to the worker’s compensation system.
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