Physical – Managing restrictions in the upper and lower limbs at work

Upper Limb use - Barriers

Fine hand coordination can be hard for people who have conditions that affect movement of the hand. Conditions that can affect fine hand coordination include acquired brain injuries, quadriplegia, upper limb conditions, including carpal tunnel syndrome and tendonitis, or neuromuscular diseases such as multiple sclerosis.

Fine hand use is needed at work for a range of tasks like writing, operating tools and equipment, driving machinery, food preparation, and handling workstation items like telephones or keyboards.

A worker may also find it difficult to lift, carry or handle items due to decreased grip strength or range of movement. Causes of these restrictions may also include pain in the arms and hands, as a result of conditions like those listed above.

Many jobs need people to use office equipment and tools for their work. Some office equipment can be hard for people to manage, particularly if they have difficulties with fine hand use.

Workplace adjustments and solutions

• where possible ensure the individual has good postural and trunk stability to maximise hand use. This can be achieved by providing ergonomic seating
• place items in easy reach to prevent over-reaching
• adaptive technology or equipment can be used to minimise or eliminate the fine hand use required with some tasks. For example, alternative computer controls like switches or eye controls
• changing the work environment for safety reasons may also be needed for a person who has coordination difficulties. This could include the provision of machine guards for industrial equipment
• tools that are used for cutting can be adapted with spring loaded pins to stop the need to open tools after each cutting action
• padding can be added to slim tool handles to optimise grip size and reduce tension in the hand muscles
• change tasks regularly to reduce prolonged or repetitive activity in the hand and wrist, like alternating keying or mousing tasks with other duties
• use power-assisted tools that eliminate the need to use manual force
• use tools that are designed to keep the wrist in a neutral position, so that any force applied does not place excess strain on the wrist
• use tools with non-slip grips, or wear non-slip gloves
• for leverage, where possible, use  tools (such as a crowbar) with a longer lever arm. The longer the lever arm the less force is required
• consider the use of foot operated instruments/controls
• adapt working position by changing the position of the work area relative to the worker by using adjustable tables and stools
• use light weight tools/instruments which place less stress on the muscles, hands and arms
• consider the use of voice activated software and speech to text software
• consider the many solutions available to help with using office equipment and tools for workers with reduced fine motor skills through alternative mouse and keyboard controls.

Other solutions to overcome pain from keyboard or mouse use include:

• take short stretch or postural breaks on a regular basis
• ensure the work set-up allows the upper arms to rest comfortably by the torso when working so that a person is not reaching out away from the body
• perform upper limb stretches at work to reduce the cumulative impact of repetitive fine motor use
• practice using the mouse with the non-dominant hand to promote alternating between both hands
• learn keyboard shortcuts to reduce mouse use
• ensure the job requirements are within the person’s physical capacity

Reaching

Reaching for equipment can be hard for people who have limited movement in their arms and hands, back or neck pain, physical disability or any other condition that makes reaching difficult. Reaching can cause pain, strain or simply may not be possible due to a person’s physical limitations.

There are several products, aids and supports to help people to reach, or reduce the risks associated with reaching. Jobs where answering the telephone is a large part of the role, like in a call centre, supports such as headsets, hands-free telephones and accessible call centre systems can be used.

Reachers, step stools and order pickers can help people to pick up items that are above their head height.

Lower Limb Barriers

Moving from one place to another is needed at work and in daily activities. Injury or disability can have an impact on a person’s mobility in their daily life.

There are modifications and adjustments that can be made to the workplace to help people with restrictions to their mobility. For people with severe mobility restrictions, mobility training by an allied health professional may be needed. Where a worker needs support on an ongoing basis, they may be eligible for help at work through the National Disability Insurance Scheme. For more information, visit the NDIS website.

Workplace adjustments and solutions

Mobility at work can be supported by different workplace modifications, products or solutions, like:

• changing the layout of the office to adapt for specific mobility needs
• relocating specific workspaces to a more appropriate area.

People with mobility restrictions who use walking aids, scooters or wheelchairs can be helped to be independently mobile by making sure:

• pathways, walkways and entrances are clear
• mats are removed to avoid trip accidents
• small steps or door lips are changed to ramps for ease of mobility
• the width of doorway entrances to facilities like bathrooms, kitchen and offices allow access for walking aids, scooters and wheelchairs
• emergency exit requirements are accessible.

Walking

Being mobile by walking takes strength, range of movement and coordination, which may be affected by disability, a health condition or injury. For example, a person with rheumatoid arthritis, may find it hard to walk due to weakness, pain and fatigue. A person with spinal cord injury may find it hard to walk due to paralysis, weakness or changes to sensation.

Workplace adjustments and solutions

Jobs like sales, store and cleaning jobs require lots of walking. General changes to the workplace can reduce the impact on the body from long periods of walking;

• correct floor coverings, like: anti-fatigue matting; carpet alternatives; non-slip surfaces
• wearing work appropriate and supportive footwear with cushioned shoe inserts or orthotics if needed
• change between sitting, standing and walking during the day - if possible.

Working while standing

Working in a standing position may be difficult for a person with disability, and for prolonged periods can also have negative effects on a healthy body. When doing work from standing, it is important to look at the position of each part of the body including the neck, head, arms, hands, back, hips, legs and feet and aim to set up work tasks between hip and shoulder height wherever possible.

Workplace adjustments and solutions

Working as a chef, shop assistant, production line worker, customer service assistant, hairdresser, restaurant attendant, nurse or teacher usually requires working from standing. This may involve doing tasks:

• above head height
• in mid-range
• lowered in a standing or stooping position

Use safe work practices when working in a standing position, such as:

• propping a foot on a small ledge while standing to help change the postural loads from static standing
• doing stretches and work exercises on a regular basis
• taking regular postural breaks, for example, after every 20 to 30 minutes of standing, complete a seated task, or walk for 2 to 3 minutes
• where possible, change between sitting, standing and walking regularly.

It is also very important to have well-fitting comfortable footwear, suitable to the work environment when standing for long periods. Orthotics or moulded footwear may help for some disabilities.

It is important in each job to reduce the risks of working from a standing position. Where possible, the job and work environment should be designed to fit the worker. This could include:

• elimination and substitution - consider if work needs to be done in a standing position, or if there is an alternate way to do a task
• minimisation - try to decrease the frequency or repetition of a task if working from standing
• engineering - can the work station or work environment be changed to reduce the risks or difficulties for the employee? For example, ensuring work is in mid-range and tools are easy to reach to minimise stress on the body
• administration - changing work systems and practices for example, rotation of workers to reduce the amount of time any one person has to work from a standing position
• training and supervision - ensure employees operate equipment safely and use safe work practices if working in a standing position, for example performing regular stretches and changing postures if possible
• personal protective equipment - like wearing supportive footwear and the provision of anti-fatigue matting.

Products, aids and supports to help people who need to stand for long periods include:

• use of anti-fatigue matting or innersoles
• use of an ergonomic chair or perching stool
• changing the height of the table or use of a height adjustable table or a sit/stand workstation, especially where there is the rotation of workers of differing heights
• use of a stand-up wheelchair, where a wheelchair user’s work tasks require varying heights to enable access.

Climbing

Climbing involves ascending or descending structures or objects using the feet and legs, and or hands and arms. Climbing ladders, stairs, poles or posts, scaffolding, ramps or environmental aspects can be part of many jobs and can be hard for people with physical or sensory disability.

Climbing and working at height can be an occupational health and safety risk in a workplace. Employers or people who are self-employed have a responsibility to assess safety risks and find ways to prevent or control the risk of injury for employees.

Workplace adjustments and solutions

If a person finds climbing hard, or if climbing presents potential risks for them, the following adjustments can help:

• elimination and substitution - consider removing or eliminating an employee's requirement to climb
• minimisation - decrease the frequency of climbing if possible
• engineering - use of handrails, stair lifts or more regular landings built into ramps
• administration - modify work systems and practices for example, job rotation and good housekeeping
• training and supervision - training to assist with safe work practices for climbing to prevent falls from heights and ensure workers operate equipment safely and properly to minimise climbing risks
• personal protective equipment - for example, provision of gloves or harnesses.

Related Links

Independent Living Centre Australia
Guidance on the Principles of Safe Design for Work

Last updated: 23 May 2018 - 4:10pm