Computer analyses injuries

Computer-assisted functional capacity evaluation is to provide the data for running and assessing an Irish pilot programme aimed at getting people with back problems back to work much faster than at present.

The programme, called Start Back, has been devised by the Abbey Physical Evaluation and Training Centre in Limerick. The centre uses the only computerised Blankenship functional capacity evaluation system in the State, both for assisting in the resolution of accident claims and for providing feedback to determine when physiotherapy patients can safely return to work.

The objectivity of the Blankenship system in measuring a participant's ability to work will be a key part of the Start Back programme, because an early return to properly chosen light duties is an important part of the approach.

Volunteers for the pilot programme will be tested before commencement to provide baseline data for comparison with tests both during the programme and afterwards.

The Blankenship system helps the physiotherapist to identify what the person can do without damaging prospects of recovery. Often, a person can successfully return to work if the physical demands are adjusted a little, or adapted equipment is used.

The equipment includes means of testing the ability to lift various weights through differing heights, to pull different weights on a sled, to assemble small parts, and so on. "It can even test what your little finger can do," according to the Abbey Physical Evaluation and Training Centre director, chartered physiotherapist, Ms Annette Shanahan.

Sensors built in to the equipment, such as force gauges, are linked to a laptop computer with a Pentium processor to give readouts on strength, flexibility, range of movement, endurance, and consistency of effort, and so on. The tests are done using the actual movements and positions that the person would use at work in his or her particular job. The results are immediately compared with the standard for a person of the same age and build, and discrepancies are indicated on the computer screen in graphical and numerical format. So it is possible to state, for example, that the subject shows say, 27 per cent weakness in the left arm, and 38 per cent in the left leg, rather than using qualitative, subjective terms, such as mild, moderate and severe.

"An important aspect is that the system also compares performance with that of an international database of people with similar injuries," said Ms Shanahan. "The database is growing all the time, and now has data on over two and a half million people."

The database provides adjustments for age, sex, height, weight and ethnicity.

The comparison is done in real time, using a direct 28.8 kb modem link from the laptop to the host computer in Atlanta, where the database is held. Start Back is the first rehabilitation programme of its kind in Ireland, according to Ms Shanahan, who says it could contribute to lessening the cost to the Irish economy of back problems. The costs arising from manual handling injuries alone was £50 million in 1995, she says, quoting ICTU figures.