A standardized stretching program with ergonomics training helped one manufacturer reduce lost-time injuries significantly.

The Benefits of Stretching

Outcome measures helped to make this manufacturing company's workplace stretching program stick.

The concept of performing stretching or "exercises" at work is not new. There are several studies that demonstrate the physiological benefits of stretching [1-5]. Other studies indicate stretching in the workplace can be beneficial in reducing muscle-related discomfort and musculoskeletal disorders [6-7]. Two recent studies conclude stretching should be part of an overall injury prevention program and indicate "stand alone" stretching initiatives are not as effective [6-7].

A standardized stretching program with ergonomics training helped one manufacturer reduce lost-time injuries significantly.From a safety viewpoint, it is the ability to measure and monitor progress that is critical to a successful injury prevention initiative. In 2006, a manufacturing facility implemented a comprehensive ergonomics program that specifically focused on identification and implementation of controls to reduce the frequency and severity of musculoskeletal disorders (MSDs), or "soft tissue injuries." Ergonomics training was provided during a period of nine months for all supervisors and employees. More than 180 "ergonomic opportunities" were identified and addressed through the training process. Top management demonstrated its commitment to the company's prevention efforts by providing the necessary resources and capital to support the overall MSD prevention initiative.

The company implemented a standardized workplace stretching program following the ergonomics training. The stretching program involved all of its production employees, including machining, assembly, and shipping/receiving areas. Several key elements were integrated into the process to guide the employer with developing, implementing, and monitoring the stretching initiative.

Participation was mandatory and included more than 400 employees. A total of 42 "Stretch Coaches" were trained by a licensed physical therapist. Each "Stretch Group" consisted of six to 12 employees.

Very Positive Response
A Pilot Outcome Study was developed to assess the impact of the stretching initiative. To measure employee "buy-in" and satisfaction, the Stretch Coaches completed surveys at six, 12, and 18 months. One hundred percent of the Stretch Coaches returned the surveys. Demographics of the completed surveys are identified in Table 1. The company’s safety team agreed to utilize injury rates and employee satisfaction to monitor the overall effectiveness of the program. Injury rates were tracked utilizing the OSHA 300 Log. The 42 Stretch Coaches completed participation surveys as a means of obtaining feedback at the six, 12, and 18 months intervals following the launch of the stretching program.

Total Number of Surveys Distributed: 42
Total Number of Surveys Completed: 42
Survey Return Rate: 100 percent
Gender: 19 males, 23 females
Average age: 40.1 years
Average Years of Service: 12.5

As a result of its comprehensive efforts, the company experienced zero lost workday cases in 2007 and only two lost workday cases the following year. These results represented a 67 percent reduction of lost work day cases from the previous five-year average. In addition, a 50 percent reduction in MSD-related cases was realized. This reduction included both OSHA recordable and first-aid cases.

The participant feedback survey consisted of five questions specifically related to the stretching program. The results revealed the employees' perception remained very positive at all three intervals when the survey was completed. Satisfaction was measured using a numerical rating scale of 1-10. When asked to rate how beneficial the stretching program had been for them, the average response ranged from 7.5 to 8.2, which the employer interpreted as a "very positive" response.

Seventy-five percent of the participants felt stretching should "definitely" be performed twice a shift. Eighty-one percent of the respondents felt "no changes" to the stretches were needed. More than 50 percent of the participants indicated they performed at least one of the "group" stretches during their shifts outside of the scheduled stretching times. This demonstrated a definite change of safety behavior in the work culture.

Both Metrics and Program Structure Matter
So what can we conclude with this pilot outcomes study? Prevention of work-related musculoskeletal disorders (MSDs) requires a variety of approaches because no single approach or solution has been shown to have an overwhelming effect on reducing injuries. A structured employee stretching program, combined with a more comprehensive ergonomics process, can have a positive impact in reducing MSDs.

This study also reflects that measuring data, such as employee feedback and reduced injuries, is critical to achieving positive results. Simply monitoring the frequency or severity of injuries on the OSHA 300 Log is not enough to sustain an effective MSD-prevention program. Other outcome or "quality" measures, such as employee feedback surveys, and other leading indicators must be incorporated to determine the overall success of a workplace stretching initiative.

Metrics such as these allow employers to make necessary adjustments to their stretching programs before signs of failure occur. These results raise the possibility that perhaps the overall success of a workplace stretching initiative depends not only on the structure and specific type of stretches employees perform, but also on the metrics utilized to track success.

1. Fenety, et al.; "Short Term Effects of Workstation Exercises on Musculoskeletal Discomfort and Postural Changes in Seated Video Display Unit Workers," Physical Therapy, Vol. 82, No. 6, June 2002.
2. Hansford, P.; et al.: "Blood Flow Changes at the Wrist in Manual Workers after Preventative Interventions," Journal of Hand Surgery, 1968.
3. Amako M., et al.: "Effect of Static Stretching on Prevention of Injuries for Military Recruits," Mil Med 2003,168(6):442-6.
4. Hebert, L; "Preventive Stretching Exercises for the Workplace," Orthopedic Practice, Vol. 11, April 1999.
5. Taylor, D.C., et al; "Viscoelastic Properties of Muscle-Tendon Units: The Biomechanical Effects of Stretching," American Journal of Sports Medicine Vol. 18, No. 3, 1990.
6. Hess, J. et al.; "Stretching at Work for Injury Prevention: Issues, Evidence, and Recommendations," Applied Occupational and Environmental Hygiene, Vol. 18 No. 5, 2003.
7. DeCosta B., Vieira E., "Stretching To Reduce Work-Related Musculoskeletal Disorders: A Systematic Review," Journal Rehabilitation Medicine 2008; 40: 321-328.

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