A team from Spine & Sport Physical Therapy (www.spineandsport.com) and The Vert Mooney Research Foundation (DBA US Spine & Sport Foundation) (www.usspineandsportfoundation.com) will present findings of a 3-year FEMA-funded Fire Prevention & Safety grant at the 2023 American Physical Therapy Association Combined Sections Meeting. The grant (Implementation of a Regional Firefighter Wellness Initiative; EMW-2017-FP-00711; Mayer JM (Principal Investigator), Lane CL (Co-Principal Investigator), Verna JL, et al.; The Vert Mooney Research Foundation) represents the latest in a 20+ year history of collaboration between the research and clinical organizations. An abstract of the accepted platform presentation is shown below.
Schwartz S, Lane CL, Duong A, Phelps B, Verna JL, Mayer JM. Physical Therapy engagement in a regional firefighter wellness initiative: implementation and preliminary outcomes. American Physical Therapy Association Combined Sections Meeting. San Diego, CA, February 2023 (accepted).
Purpose / Hypothesis: Firefighters have high rates of musculoskeletal disorders (MSDs) and related comorbidities such as obesity, behavioral disorders, and sleep disorders. Specific guidance on implementing interventions to combat MSDs in firefighters and integrating physical therapists within occupational injury prevention and wellness programs is not well characterized. The purpose of this presentation is to describe the implementation and preliminary outcomes of a regional firefighter wellness initiative, emphasizing the role of physical therapists within an interprofessional team.
Subjects: 429 career firefighters from 15 Southern California departments participated. Eligibility criteria were broad, considering the pragmatic and practice-based design. 88% of participants had a history of MSDs.
Materials and Methods: An observational cohort project was conducted over 18 months. Assessments included anthropometric, fitness, and patient-reported outcomes, particularly for MSDs and related health risk indicators. Interventions included worksite exercise, injury prevention, and educational courses that were customized for risk levels, goals, and preferences. Interventions were delivered by an interprofessional team in one-on-one and group settings, via face-to-face and telehealth sessions. Physical Therapists conducted in-clinic assessments, fitness training at stations, and telehealth consultations. The initiative was implemented during the COVID-19 pandemic and severe wildfires, which disrupted delivery and adherence. A multifactorial approach was used to overcome implementation barriers and improve adherence. Analysis consisted of quantitative and qualitative techniques to assess awareness, behaviors, health outcomes, and implementation.
Results: 35% (138/398) and 5% (17/312) of eligible participants completed 9- and 18-month follow-up assessments, respectively. For participants at the highest risk at baseline, significant improvements (p < 0.05) were observed at 9 months in waist circumference, back and core muscular endurance, functional movement quality, exercise frequency, dietary intake, and sleep quality. Most participants agreed that “Participation in this program has motivated me to focus more on methods to improve my injury prevention, physical fitness, nutrition, sleep.”
Conclusions: Improvements in awareness, behaviors, and key health risk indicators were observed in participants of a firefighter wellness initiative. While low adherence limits generalizability, implementation during major public health emergencies provided an opportunity to inform future occupational health programs including Physical Therapists within interprofessional teams. Future research is needed to fully characterize the role of Physical Therapists within occupational health settings.
Clinical Relevance: Occupational wellness and injury prevention programs are critical for those at high risk for MSDs, such as firefighters. Integration of Physical Therapists within these settings can help enhance the health, well-being, resiliency of first responders.