Limerick hosts US system for injury testing

THE country's first high tech computerised Blankenship system is now up and running in the Abbey Physiotherapy Clinic in Limerick.

This is the system used to evaluate, the ability of an injured person to return to work and for therapeutic, and medico legal purposes.

While new in Ireland, the system is already well established and accepted in the US, where it was developed.

It is also used in Canada, South America, South Africa and Australia.

The Blankenship Functional Capacity Evaluation Testing System - its full title - documents a patient's current ability to perform work, from several perspectives physical, medical, behavioural and ergonomic.

It allows the evaluator to produce" precise, highly quantified reports, giving percentage loss of function or strength, rather than using terms such as "mild" or "significant".

Depending on the injury and the usual work of the patient, several standardised tests are used.

These include pulling on a weighted chain, lifting weights over a range of heights and assembling small parts.

Sensors on the patient's body pick up data (including heart rate) which are transferred to a laptop computer.

Various postures are also tested.

Throughout the evaluation, the computer generates a series of on screen graphs and data which show how the patient is doing, and stores these for printing.

"The Blankenship FCE process looks at the whole person and the entire body's functioning in all the work positions, postures, movements and physical demands," according to Ms Annette Shanahan, the founder of the Abbey Physiotherapy Clinic.

"It can be used to reliably give an employer information on the capabilities of an injured worker - it may be, that even if the worker cannot work in exactly the same way as before, the job can be done if minor modifications are made to it."

A chartered physiotherapist, Ms Shanahan is also a health and safety consultant, and has a particular interest in keeping people at work as much as is practicable.

"Getting back to work as soon as possible after an injury is very important, because the longer someone is away from work, the less likely he or she is to go back to it," says Ms, Shanahan.

"The tangible benefit of this system is that it addresses the gap between the patient having recovered from the pathology and being fully rehabilitated," she adds.

"From our practice in this clinic web see a need for a better interface between those who treat and those who employ, arid the new system will help this.

"It is also useful for surgeons who want to assess if a patient is ready for an operation."

As well as its therapeutic and social benefits, the Blankenship system has applications in providing medico legal reports.

"Blankenship reports don't go to court any more in the US, as they are accepted by both sides," said Ms Shanahan.

"We have already had claimants living in Ireland referred to us by UK insurance companies for assessment there are just two similar Blankenship systems in the UK.

"One of the big advantages of the system is that people can't cheat by not trying hard enough, because it immediately shows up on the graphs, so it is very objective."

"It's like a lie detector test," says the Blankenship Corporation literature.

"Certain shapes of curves generated on screen during lifting for example, indicate that the patient is not co operating with the evaluation process.

According to the Corporation, in the US about 20 to 30 per cent of patients in industrial rehabilitation programmes who have been off work for one year or longer are symptom exaggerators who are obstructing the return to work effort, and the Blankenship system helps to identify them so that they can be encouraged to try harder.

Abbey Physiotherapy Clinic system has a modem link to the Blankenship database in the US. Each patient's results can be downloaded for comparison with those of other people with a similar injury or problem, or against the norm for a healthy person.

These statistics are then included in the final report.

A full scale evaluation takes several hours and can cost up to £750 for a back injury assessment.

For reasons of commercial confidentiality, Ms Shanahan declined to reveal the cost of importing and installing the system in Limerick, which also involved training and examination periods in Georgia, USA, for herself and Abbey clinic colleague, chartered physiotherapist Ms Melissa Baker.

"I'll just say that this kind of innovative technology doesn't come cheap, and it's a long term investment for the clinic - it will take several years to pay for itself."