Cutting Edge Techniques For Functional Capacity Evaluation Utilizing

1. Cutting Edge Techniques For Functional Capacity Evaluation Utilizing Ariel Performance Analysis Systems By Robert Wainwright, P.T. President, Kinematic Consultants, Inc Point Pleasant, NJ

2. Kinematic ConsultantsTest and Measurement Servicesfor Workers Compensation IssuesSpecializing InKinematicFunctional Capacity Evaluations Utilizing “State of the Art” Technology (APAS) to Measure Function in Work, ADL and Recreation Activities.

3. Kinematic Consultants Locations

4. Test Protocols Designed and Administered by • Licensed Physical Therapists • Biomedical Engineers Kinematics

5. Medical and Workers Compensation Issues Considered • Safe Return to Work • Altered Duty Capacity Recommendation • Residual Dysfunction % • Examinee Reliability • Case Closure • Legal Support

6. Providing Support in Medical Decision Making To: • Treating Physician • Independent Medical Evaluation Physician • Case Manager • Rehabilitation Nurse • Insurance and Risk Management Personnel • Employer

7. What To Expect From An FCE? • EXAMINEE RELIABILITY during the FCE (% Effort Level and Coefficient of Variation). • RESIDUAL DEFICIT OR DYSFUNCTION (body part specific.) • GENERAL FUNCTIONAL ABILITY (activities of daily living: walking, balancing, bending, climbing, squat, reach, etc.). • SPECIFIC STRENGTH CAPABILITY (push, pull, lift). • SPECIFIC WORK CAPACITY category (Examinee’s specific and current qualification: sedentary thru very heavy). • JOB REQUIREMENTS (Job description from Employer and Dictionary of Occupational Titles). • Definitive Statement of Examinee’s capacity to return to FULL DUTY, ALTERED DUTY OR NOT AT ALL.

8. In Summary, A Kinematic FCE Answers The Following: Is the Examinee: Demonstrating maximum effort and cooperation during the FCE? Suffering residual dysfunction? Capable of safe return to work for or altered duty?”

9. How Do We Get The Answers You Need? • Standard “Low Technology” Functional Capacity Evaluation Verses • “High Technology” (APAS) Kinematic Functional Capacity Evaluation

10. LOW TECHNOLOGY FCE Traditional Toolbox Eyes Hands SUBJECTIVE Video Tape measure Goniometry

11. HIGH TECHNOLOGY FCE OBJECTIVE • 3D Kinematic Computer Analysis of Motion (APAS)* • Kinetic Ground Reaction Forces / Balance (APAS)* • Computerized Strength Analysis Equipment(CES)* • Dynamic EMG [electromyography] (APAS)* Click on the picture to see the animation * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

12. KINEMATIC ASSESSMENT:“THREE DIMENSION MOVEMENT ANALYSIS”

13. TECHNICAL ADVANCES FROM THE SCIENCE OF SPORT ANALYSIS * • Technology Courtesy of Ariel Dynamics Inc, San Diego, CA. • Click on the picture to see the animation

14. CALIBRATION (VOLUME) CUBE FOR GAIT

15. GAIT RIGHT CAMERA VIEW

16. GAIT LEFT CAMERA VIEW

17. AUTOMATIC DIGITIZING GAIT VIEW

18. CONVERSION TO STICK FIGURE AND GRAPH* * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

19. FULL SKELETON ANIMATION* * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

20. DIGITIZING A DELTA LIFT TASK ANALYSIS * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

21. Analyzing Technique * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

22. Good Lift Poor Lift * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

23. DELTA LIFT TASK ANALYSIS* * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

24. DELTA WITH 125 POUND LOAD * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

25. * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

26. * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

27. * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

28. How Do We Interpret The Data?

29. GRAPHING DATA * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

30. * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

31. * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

32. KINETIC FORCE PLATE Ground Reaction forces Newton’s Law of Physics “Every Action Creates an Equal and Opposite Reaction”

33. * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

34. POSTERIOR LEANING CENTER OF GRAVITY STANCE * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

35. EXTREME FORWARD LEANING C.G. POST LUMBAR SURGERY * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

36. BALANCE TEST PROTOCOL * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

37. BALANCE AND CENTER OF PRESSURE SWAY * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

38. LIFT TASK ANALYSIS: MAXIMUM SAFE LIFT * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

39. COMPUTERIZED EXERCISE DIAGNOSTIC ANALYSIS EQUIPMENT

40. OPEN LOOP STRENGTH TESTING * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

41. CLOSED LOOP LIFT TESTING * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

42. DYNAMIC ELECTROMYOGRAPHY “Monitoring the electrical activity of muscle groups during work activities.”

43. EMG POST KNEE INJURY AND SURGERY * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

44. ELECTROMYOGRAPHY MONITORING OF TEST PROTOCOL * Technology Courtesy of Ariel Dynamics Inc, San Diego, CA.

45. WORK SITE JOB ANALYSIS Determine if the job is a contributing factor to injury. Determine if Examinee work technique is a contributing factor to un-successful return to work.

46. Job Title: Fisherman • Sewage processing plant. Job of “Fisherman.” • General Employer Problem: multiple cases of rotator cuff and low back problems.

47. Lifts Heavy Material Well Over Shoulder Level

48. Extreme Bend Back and Knees

49. Outcome • Work technique contributes to shoulder and low back stress. • Researched plant construction and found this aeration system to be outdated. • Reconstruction not feasible. • Changed work biomechanics technique to de-stress shoulder and low back.

50. Office Worker: Chronic Neck and Back Pain • Worker suffers chronic neck and back pain resulting from multiple automobile accidents. • Job requires 90% computer terminal work. • Is ergonomic workstation or work technique a contributing factor?