FUNCTIONAL TESTING 101…

1. FUNCTIONAL TESTING 101… The Role of Function in Injury Prevention and Loss Control Programming Larry Feeler, PT, CEAS CEO, WorkSTEPS

2. Jack’s Picture

3. DEFINITION: System of ADA compliant employment tests designed to prevent injuries, control injury related costs and combat fraudulent claims.

4. Testing Customized to Look At: • Job specific strength • Baseline full body function • “Significant” medical risks • Common cumulative traumas

5. “Significant” Cumulative Traumas : • Torn Rotator Cuff (Shoulder) • Bad Backs (Neurologic) • Torn knee ligament • Carpal Tunnel • Operated Parts • ETC !!!

7. DELIVERY MODEL 650+ Medical Clinic Providers in 46 States “certified” in process Over 1,000,000 workers tested !!

8. Leggett and Platt William Charles Const. Knight Transportation Hon Furniture Nabors Drilling Frontier Airlines Waste Management Halliburton DOW Chemical MoDOT General Mills Jeanie Overhead Door Comair Loma Linda/Purdue Uni Hundreds of Cities and Counties University of Texas Dana Corporation Schenectety Heinz Ketchup Cox Communication Berg Electric Rubbermaid Austin Commercial MV Transit Fleetwood Madera ISD (CAL) Thousands More !!! Companies Utilizing Testing:

9. Employer Nightmares: New-hires • Hiring EE’s w/o measuring job related strength • Hiring EE’s w/ significant medical condition Existing EE’s • Not measuring continued job capability (physical and medical) • Not proving the legitimacy of any injury

10. Another Problem:Worker’s Comp Assumes • Worker’s are perfect when hired • Worker’s never grow old • Whatever happens to the worker, the employer caused

11. Changes in Economy • Downturns • Cut safety programs • Expand physical responsibilities • Downsizing • More qualified applicants in poorer physical shape • More protracted injuries and false claims UPTURNS You HIRE ANYYONE !! High salaries cause everyone to apply—even those who have not done physical labor in years Rejected EEs go to YOUR Co.

13. New-Hire Tests…ADA Post offer (Basic or Comp)–Most leeway May select hardest physical positions or ones with highest injuries Must test ALL applicants applying for that position

14. Post offer – Most leeway • ER may perform background checks: driving, criminal, etc • May ask applicant if they can perform specific job tasks • May interview and pick the most qualified applicant • Will hire contingent upon passing the post offer physical (just like a drug test)

15. Pretty….does it have an engine ?

17. Standardized Process for Each Part of Test Development…Job Analysis Highest Injury JOBS

19. CHANGES IN PROCEDURES

21. LIFTINGSIDEWAYS… • WRONG • Education Classes

22. LIFTINGSIDEWAYS… • RIGHT

25. VIBRATION

26. Static Postures

27. Carpal Tunnel… • 1/3 occur in first year of employment • 15% occur in first 3 months • $30,000 ave cost • 34 lost days per claim • $50-300,00 with surgery • 90 lost days with surgery CTD News 2004

31. Accurate Essential Function Descriptions: • 18.5” Step up 5x • Lift and carry 75 lb tool box 30 feet on uneven terrain, kneel … • Lift from ground and place or throw 48” skids to a height of 60 inches. Must accomplish up to 25 reps under 80% MPHR • NIOSH force: Floor lift--100 lbs. To overhead-55lbs, Push 100 lbs

32. STRENGTH Standard NIOSH boxes • 4 Postures • Body mechanics training • Must lift enough to attempt job related tests

33. Shoulder to Overhead • Instruct in proper body mechanics • Avoid twist while lifting • Give max safe limits

34. KNOW YOUR LIMITS and GET HELP !!!

35. JOB SPECIFIC TESTS • Posture • Repetition • Force • Aerobic Demand • “Virtual” Testing

40. Cardiovascular Tests…

44. “Baseline”FullBodyMusculoskeletal Eval:Evidence Based !!!! • Posture • Range of Motion (IMP measures) • Joint Flexibility/ Wear and Tear • Strength • Palpation • Investigation of Damaged Parts • Medical evidence to support “not capable” for medical risk

45. POSTURE

47. Medical Tests

48. PALPATION

50. Centinela’s / Empty Can Rotator Cuff Test