Occupational therapy intervention for overuse syndrome.

This article was accepted for publication July 19, 1990. I n the past decade, occupational therapists involved with the rehabilitation of work-related musculoskeletal injuries have seen an astounding rise in the number of upper-extremity disorders. Various names have been given to these disorders, including repetitive strain disorder, cumulative trauma disorder, and overuse syndrome. All descrihe physical symptoms of persistent pain in jointS, muscles, tendons, or other soft tissues of the upper extremities. Many of these cases manifest themselves during work or leisure activities involving upper-body repetitive motions (Kroemer, 1989). A review of the literature reveals three main causes of occupationally induced overuse syndrome: (a) rapid repetitive movements; (b) less-frequent forceful movements; and (c) static loading, which is defined as the work the muscles must do to hold body parts in certain positions (Bammer & Blignault, 1987). Repetitive motions of the upper extremity occur frequently at the workplace. A data-entry operator may perform 20,000 keystrokes an hour, an assembly line worker may raise the dominant shoulder above acromion height 7,500 times per day, and a meat cutter may perform an average of 12,000 knife cuts per day (Snook, Fine, & Silverstein, 1988). Recent changes in industrial production methods may have precipitated the dramatic increase of overuse syndrome. For example, in the meatpacking industry, butchers used to work individually on carving whole carcasses. Several types of knives and knife strokes were used, thus providing variety in body movements and hand-grip specifications. Over the last two decades, however, the process of butchering cattle and hogs has been transformed into a high-speed assemblyline approach. Each worker makes the same knife cut several thousand times a day, resulting in a dramatic increase in production as well as a significant rise in overuse syndrome (Roel, 1989). Occupational therapists use a variety of intervention strategies to treat overuse syndrome, including splinting or casting for immobilization, education in proper hody mechanics and anatomy to minimize risk of reinjury, pain management techniques such as ice massage and pain medication, home modifications, and relaxation or stress management techniques. None of these treatment techniques, however, will help an injured employee return to his or her work environment unless modifications are made to the physical parameters of the job or the employee is allowed to modify his or her work behaviors. The present report describes occupational therapy intervention in the workplace with a printing company employee With bilateral upper-extremity overuse syndrome.