Purpose
PurposeThe purpose of the Orthotics Pilot Study was to determine if Ergonomic Medical Grade Foot Orthotics would prevent and reduce musculoskeletal symptoms and associated diseases effecting load bearing joints of the body. These biomechanical conditions create bone, joint, muscle fatigue, strains, sprains and lost days in linemen and groundsmen in the T&D divisions within SCE which leads to a high workers compensation claim history.

Custom orthotics are used in the prevention and treatment of disease and injuries in Olympic and professional athletes. In addition, physicians have used them in the treatment of disease and injury in medical patients for many years and their efficacy should provide similar benefits for a working population such as the group within our study. We believe that by providing Ergonomic Foot Wear solutions, we will be able to prevent injuries and disease and improve the quality of life by providing more comfort and improving function and thereby enable SCE to proactively manage and reduce workers compensation claims using biomechanical – ergonomic intervention programs.

It is also hypothesized that the utilization of the 3DO System for testing and electronic casting will result in superior orthotics than those produced from conventional casting methods. The ability of the 3DO System to gather comprehensive data on static load bearing pressure points, weight distribution, and gait testing provides the tester and orthotics lab with important additional information in creating more advanced orthotics. Further, the portability of the system and the speed of which testing can be completed lends itself to mass customization in industrial applications.


History
For 60 years, Ergonomic Orthotics have proven to be effective modality in minimizing or eliminating symptoms in patients with neck, shoulder, spine, hip, knee, foot and ankle problems by focusing on maximizing closed kinetic chain mass displacement, (weight) effecting the body by controlling complex tri-motion function of the foot as it impacts the ground.

A health questionnaire was designed and circulated to determine the scope and nature of the problems. Upon written interviews with the linemen and groundsmen, 65% responded with the complaint of various chronic musculoskeletal pains including the lower back, neck and shoulders.  

Method
Edison employees at two service centers were offered the opportunity to volunteer for a pilot study to evaluate the effectiveness of Orthotics. They were given a free scanning of static and dynamic weight-bearing on a dual functioning 3-D static and dynamic Imager. Those who demonstrated abnormal scans were then recommended to purchase Orthotics at a significantly reduced rate understanding that they came with a 100% satisfaction guarantee for a full refund. Of the 112 employees available, 70 entered the study with the understanding that were would be a 1 month, 3 month, and 6 month follow-up.   

Six Month Follow-up Survey Summary:* Only 41 employees where available the day of survey collection.
* 4 had either never worn or stopped wearing them for various reasons
* 2 employees had complaints that were related to the shoe/boot and are being resolved.
* Does the Orthotic help you with your job? 62% Yes, 20% sometimes
* Do you have less pain now (prior to health questionnaire) from using the Orthotics?
o 20% said a little
o 40% said moderate improvement
o 25.7% said significant improvement 
* Help improve chronic problems? 57% Yes, 20% sometimes, 14% No
* Do you wear them daily? 86% Yes, 11% sometimes, 3% No
* Rate the value? 37% very valuable, 49% somewhat valuable
* Would you recommend Orthotics to your family and friends?
* 86% said Yes
* 10% said No 



Data Results Discussion
The subjective data reflects a positive response from the T & D linemen and groundsmen.

The purpose of the pilot study is to determine the effectiveness of the Orthotics at addressing the following concerns:



Does it help with the job?
The survey shows that 62% of the employee available on the day of data collection felt that the Orthotics helped them with their jobs.

Is it reducing physical symptoms and complaints?
Almost 86% responded with either a little, moderate, or significant improvement with the use of the Orthotics.

Is it helping in reducing or preventing injuries?
Both service Centers report that there has not been an injury or accident since the beginning of the study.

Additional Notes
At one month and three months, phone surveys were conducted at random. Results were favorable and most complaints were resolvable with Orthotic adjustment.  The six-month survey (see attached) has places for written feedback. Most of the employees had both written and verbal positive feedback. It is my recommendation that we continue to locate the other members in the study and collect their comments.

Conclusion
The preliminary results which represents a four month ( Huntington Beach) and six month (Saddleback) evaluation demonstrates and confirms in part the effectiveness we were attempting to prove. It must be noted that further symptom reductions will occur over the next six to eight months as the workers continue to wear and comply to the utilization of Ergonomic Orthotics. The goal is to stress the importance of wearing Orthotics as much as possible (work, home, sports and play). Generally compliance should be good because of the benefits (relief of pain, fatigue etc…), however we may want to consider some educational material and follow-up to ensure compliance which will justify greater benefits to employee and employer.

There were also considerable problems noted in the boot wear being worn by employees. With the mechanically demanding positions and environments the T&D workers are faced with many of them wore improper foot wear (oxford shoes, cowboy boots, and severely broken down foot wear). We attempted to educate them on proper fitting boots, but it is apparent we could have had even greater results if we had a compliance program which met recommendations established by OSHA, NIOSH. The Orthotic is only as good as the boot in which it fits. Especially in cases with broken down foot wear which distorts the quality of biomechanical control of the Orthotic since the Orthotic is meant to work in a bottom sole which is parallel to the floor surface.


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