“An Injury Prediction Tool for Physically Active Employees,” presented by Larry Cassella Jr., program manager for HealthFitness, working on-site at the town of Cary in Cary, N.C., at the Health Benefits Conference & Expo, Jan. 29-30, 2013. To read a blog post with details about this presentation, visit http://healthfitness.com/blog/how-basic-movement-can-decrease-employee-health-care-costs/

1. Can Improvements in Basic
Movement Patterns Lower the
Cost of Workplace Injuries?

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Demographics
Poor Nutritional Habits
Lots of StressPhysically Active
Trying to be Healthy

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The Challenge

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Workers’ Compensation Cost Overview
Musculoskeletal Injuries (MSI’s)
Public Works (all divisions)
• 735 MSI’s totaling $2.9M
Police Department
• 258 MSI’s totaling $1.4M
Fire Department
• 338 MSI’s totaling $1.1M
1,608 MSI’s during last 10 years totaling $6M

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50% of Total Costs are Preventable
$K
$100K
$200K
$300K
$400K
$500K
$600K
$700K
$800K
$900K
$1000K
FY '09 FY '10 FY '11
$757
$788
$1M
$426
54
$387
56
$691
77
Total Workers' Comp Costs
Musculoskeletal Injuries (MSI) Costs

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Gaining Leadership Support
1. Identify movement-based cost drivers
2. Solution must be based on sound science and
a. easy to implement
b. quickly identify movement limitations
c. measurable
d. provide instant feedback
e. goal-orientated
3. Can be applied in the worksite or fitness environment
4. Identifies movement need—creates customized treatment plan

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Gaining Participant Support
1. Voluntary program
2. Never punitive
3. Short time to complete
4. Easy to improve
5. Simple goal of balanced flexibility and strength
allowing participant to create realistic goals

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Participant Flow
Scoring of
Assessment
Physical Labor Screening
Low Risk Moderate
Risk
High Risk

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How do we treat other health care issues ?

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Is this a bad movement or have we
just become bad squatters?

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Screen for Fundamental Movement Ability

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What has been observed ?
Overall Workers Comp Cost: Orange Co. Fire Service
Provided by Mike Contreras, CSCS

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Injury Validity: Functional Movement Screening
Study Journal Population n Cut
point
+LR (95% CI)
Kiesel et al.,
2007
NAJSPT Professional
Football
46 ≤ 14 5.9 (2.0 - 18.4)
O’Connor et
al., 2011
MSSE Marines in
Basic Training
874 ≤ 14
≥ 18
1.8 (1.3 - 2.7)
1.1 (0.9 – 1.4)
Chorba et al.,
2009
NAJSPT College Fem.
Athletes
38 ≤ 14 3.9 (0.9 - 5.1)
Butler et al.,
2013
Work Firefighter
trainees
108 ≤ 14 2.2 (1.6 - 3.2)

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Marines FMS Score Association with Attrition
Cycle FMS Score Number
Attrition
%
Risk Ratio P-value
Injury
Attrition
FMS Score
<14
57 12.3
3.90
(1.60-9.49)
<0.01
FMS Score
>14
381 3.1
Marines with FMS scores <14 had nearly four times the risk of
injury attrition when compared to Marines with scores >14.

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Local impact / application

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Participant Flow
Scoring of
Assessment
Physical Labor Screening
> 14, Has no
asymmetries
Scores a
≤14, a 1, or has a
+/- 2 asymmetry
“0” = Pain on any
clearing exam or
movement

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Firefighters ‘At Risk’ Who Completed
Intervention Improved

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Movement Limitations across Patterns

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Greatest Movement Limitations Align with
Essential Functions of Job
(FD T1 was January 2011) (PD T1 was January 2012)

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$K
$20K
$40K
$60K
$80K
$100K
$120K
$140K
$160K
$180K
$200K
*2000 -
2007
2008 - 2009 2009 - 2010 2010 - 2011 2011 - 2012
$3 $10
$89
$156
$34
$3
$189
$4
$83
$0
Fire Department Police Department
Program Impact
Clear Reduction in Number and Severity
of MSI’s In One Year
* FD: 318 MSI’s totaling $1M, average cost per MSI $3,145
PD: 251 MSI’s totaling $807K, average cost per MSI $3,215

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How Would You Start an FMS Program?
• Create a detailed business plan
• Follow all HIPAA, ADA and other employment laws
• Get top-down leadership support
• Communicate effectively to employees, e.g., why is
this important to me? How will this benefit me?
• Create a detailed tracking procedure
• Measure success, e.g., musculoskeletal injuries,
severity of injuries, time away from work, etc.

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Contact Information
Larry P. Cassella, Jr.
MS Kinesiology
Program Manager
HealthFitness
Phone: 919.380.4449
Fax: 919.319.4567
www.healthfitness.com
Robert J. Butler, PT, Ph.D.
Assistant Professor
Division of Physical Therapy
Department of Community Health
and Family Medicine
Associate Director
Michael W. Krzyzewski Human
Performance Lab
FIFA F-MARC Center of Excellence
Department of Orthopaedic
Surgery
Duke University
Durham, NC 27705
Phone: 919.681.7225
Fax: 919.668.1957