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Ergonomic products help PTs, patients
Monday May 13, 2013
An Equipois x-Ar arm assists Hasbro factory workers. DPT students led by professor Patrick Carley, PT, adapted the arm cuff so it was more comfortable for the workers.

(Photo by Patrick Carley, PT)


As technology advances, workplaces rapidly add new equipment to offices, factories and clinics. However, their employees still have the "same old human body," according to Patrick Carley, PT, DHA, MS, professor in the DPT program at American International College, Springfield, Mass. "The whole idea behind ergonomics is matching the person to the work." A new batch of ergonomic products are designed to help people work, garden, rest and move in different settings while avoiding pain, injury or lost productivity.

In the office

Ergonomics specialist Kristie Elton, MSPT, OCS, has been a PT for 19 years. She is responsible for the ergonomics program at 10 campuses and five medical centers in the University of California system. One of her favorite products is the Contour Design RollerMouse, which she recommends for any worker having a problem with the neck, arm, shoulder, wrist or hand on the mouse side. The RollerMouse reduces repetitive motions and unnatural positions.

RollerMouse R:ed is an updated version of the companyís ergonomic mouse.
(Photo courtesy Contour Design)
"You can use your whole hand to work the bar, then click with the other hand," James Golden, CAE, director of marketing at Contour, said. The RollerMouse Free2 has a button users press once to doubleclick, cutting the number of clicking motions in half. The button is wider on the new version, R:ed, scheduled to be released this year, Golden said. The R:ed also has a wider roller and an aluminum body so it can be mounted onto a keyboard tray, he said. Elton, who tested a R:ed prototype, said the wider roller is good for people with hand arthritis, and the user adjustability is improved.

"You find a lot of companies who try to address the issue by designing the user in the same posture," said Bret Hudson, who has a masterís degree in biomechanics and works in sales and consulting at Contour. "We try to promote healthy ergonomic behavior, promoting a variety of movements."

Other office tools Elton likes include monitor arms — great for collaborating with others and easily adjusting the monitor position — and keyboards such as the Kinesis Freestyle Solo or the Goldtouch Ergonomic keyboard, which can be adjusted to customize tilt and angle for each person. She said Ergotron offers WorkFit height-adjustable workstations, which allow workers a more affordable option to sit and stand.

Elton said she also emphasizes healthy work habits including taking breaks and moving. "Even though you could be set up in the most perfect ergonomic environment, if youíre sitting in it for eight hours without a break, youíre still going to end up hurt," she said.

PTs can use KnotOut to save their hands during manual therapy.
(Photo courtesy LaVita Forte)
Clinics & beyond

When it comes to crutches, Mobilegs Ultra addresses some major issues with traditional crutches: abrasion, secondary injuries from use and risk of falling, according to Jeff Stoner, vice president of sales and marketing at Mobi LLC. Stoner said the ergonomic crutch was developed after designer Jeff Weber spent about eight weeks using crutches after an injury. Weber ended up with injuries to his wrists and underarms, Stoner said, so he started reimagining the crutch.

The saddle portion of Mobilegs Ultra that fits under the arm is designed to eliminate abrasion and bruising of the soft tissue, Stoner said. "It allows that saddle to stay stationary under the arm because the leg moves in the saddle as you stride," he said, adding a traditional crutch moves under the arm with each stride. The mesh material of the saddle allows ventilation, and works with a spring on the underside to serve as a shock absorber if someone puts more weight on the crutch, Stoner said.

Mobilegs Ultra also has an angled hand grip to keep the personís wrists in a neutral position while bearing weight, he said. Combined with an arc in the legs, this gives hip clearance and allows the user to keep the crutch closer to the body, making navigating easier, Stoner said. "It also creates a more upright stance, which prevents the person from being tipped in a less optimal position," he said. The large rocker feet stay in contact with the ground throughout the stride, Stoner said. The Mobilegs Ultra have a 300 pound capacity and are about 30% lighter than traditional crutches, he said. One size also adjusts to fit people in the range from 4-foot-9-inches to 6-foot-4-inches tall.

The KnotOut is a portable, muscle adhesion release tool that PTs can use in the clinic and also send home with patients for prescribed exercises, according to Tom Allen, an engineer and one of the productís creators. The idea for the KnotOut came after Allenís trainer gave him two tennis balls taped together for spinal mobilization. He liked it, but thought he could come up with something better than dealing with the taping. The KnotOut is made of two balls inside a polyolefin sleeve, and comes in four different sizes and two densities, Allen said. The outer sleeve holds the two balls in tension, but still allows them to move a little bit, and the shape makes it easy to work muscles on both sides of the spine without touching the vertebrae, he said.

Jessica Streiff, CPT, CES, exercise therapist, vice president of research and marketing for KnotOut, worked in a PT clinic when they were developing the different versions of the KnotOut. "The extra small ... has proved very beneficial for anyone suffering with carpal tunnel or any kind of tightness in their forearms, tightness in their elbows," she said. "It can also be used as a trigger point tool, if itís turned in the opposite direction." The small can help address foot, ankle and calf tightness and plantar fascitis, while the medium is for occipital release, spinal mobilization and lower extremities, she said. The large has similar uses as the medium, but for bigger patients.

Home, garden & workplace

Amy Wagenfeld, OTR/L, PhD, CAPS, an occupational therapist, educator and master gardener, said her favorite hand tools are the Radius Garden tools, which have a patented, curved handle that allows gardeners to keep their hands and wrists in a neutral position. "Itís well-designed because it transfers the energy used to the upper part of the arm and shoulder rather than the wrist and hand doing all the work," she said.

The smooth handle also is better than one with indents for fingers, Wagenfeld added. "Any type of garden tool with hand grips is not good because it implies where the hand grips," she said. "So it forces your hand into a position where you have to work for the garden tool instead of the tool working for you."

Wagenfeld also recommends telescoping tools that can change length, allowing someone to garden seated or standing. She likes Nitrile gloves that allow gardeners to feel what they are doing. And she likes handles such as the Back Buddy Backsaving Handle that allow for a two-handed grip when using tools such as shovels or rakes.

"Itís very meaningful and purposeful to be engaging in any garden-related activity," said Wagenfeld, who is co-writing the book, "Designing the Healing Garden," which is scheduled to be published in 2015. "Itís much more realistic for someone whoís working on ambulation skills to be outside than in a clinic."

BackJoy Orthotics LLC, the creator of the BackJoy Posture+ seat, which prevents people from slouching when seated, redesigned the pillow to help people stay in a more neutral posture when sleeping. Posture Sleep is designed for back or side sleep and uses memory foam and DualDown fill to maintain support, according to Mike Mackay, marketing director at BackJoy. In either sleeping position, it is designed to keep a personís head the correct height from the bed, and the neck in a natural position, a curve for back sleepers and a straight line for side sleepers, according to Mackay.

PTs are uniquely suited to ergonomics work because they can make modifications to a workspace, but they also can teach the workers how to stretch out, Carley said. He and DPT students are starting a project using spring-loaded exoskeletal arms to help employees making Hasbro games. During the pilot, he said the workers adapted well and reported more endurance and fewer injuries. The arms being used in the project are x-Ar made by Equipois, and are lightweight with an adjustable spring, he said.

Carley thinks exoskeletal arms will be very useful in the future because they have the potential to be used in many different settings or fields other than manufacturing. "If doctors are doing long surgeries, their arms are going to get tired," he said. "Also, as the population ages, the use of exoskeletal arms could actually help people function." •

Bonnie Benton is a copy editor.

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Monday May 13, 2013
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