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Corporate studies conducted in the 90's show lower Carpal Tunnel Syndrome incident rates among the companies using the CATS PAW Hand Exerciser as part of their ergonomic programs.

Seattle City Lights

Gary Zarker, Acting Superintendant
Norman B. Rice, Mayor

DATE: May 12, 1995

TO: Dolores Nizich,Manager Safety, Health and Wellness Unit

FROM: Keven Mosley-Koehler, Wellness Coordinator Safety, Health and Wellness Unit

SUBJECT: Cats Paw Trial/Brite Idea#

In November 1994 Ray Anchan, City Light employee, submitted a Brite Idea that suggested the utility could reduce Industrial Insurance costs by providing employees at risk for Carpal Tunnel Syndrome with a small hand exercising device called the Cats Paw.

Ray noted in the Brite Idea that he had suffered from painful (CTS) symptoms for years and tried many treatments but found little relief, until he started using the Cats Paw. He bought the item at a local pharmacy and began using it daily.

Ray said he had immediate results and his symptoms have nearly vanished. Now he uses it about every other week for a few days, as a preventive tool.

Since the Cats Paw is rather new and has not been extensively tested, we conducted two pilot studies, where we had employees use the device daily, comparing the severity of their symptoms first before, and then after using the device for four weeks.

Attached is the summary of the trial results as well as the raw data.

SEATTLE CITY LIGHT

Keven Mosley - Occupational Health Specialist TRIAL #2

November 6, 1995 thru Feburary 6, 1996

CATS PAW HAND EXERCISER, for relief and prevention of Carpal Tunnel Syndrome and Repetitive Strain Injuries.

Note: Study protocol and questionnaires originally developed by Santa Barbara Medical Foundation Clinic.

This second study was run to reconfirm the positive results of trial #1 (see attached) and to test the Cats Paw with a more specifically heavy PC user group.

The group chosen was the Customer Service Representatives of the SCL Account Services Division. Marie Powell, Executive Assistant to Director Clair Lewis, ran the study with Keven Mosley of Safety, Health and Wellness.

RESULTS
In groups A and B, participants with current symptoms, 62% of participants reported symptom improvement or elimination and 76% would recommend the Cats Paw. In the preventative group C, 56% would recommend Cats Paw and 44% had no opinion. No one in group C had any symptoms at the start of the test or developed any during this study.

These results are very similar to all previous study data.

METHOD
During a late October staff meeting, volunteers were requested for a 2-month subjective study of the Cats Paw hand exerciser. The study included a pre-trial (#1) and post trial (#2) questionnaire and a log sheet to record daily use. Doctor release forms for participants in group A (most severe) were encouraged to be completed and turned in and required of anyone under current care.

Over 60 employees expressed interest and showed up for training on November 1st and 2nd. By the end of February 1996, 35 had completed and turned in enough information to be considered in the final evaluation.

Questionnaire #1 was completed prior to issuing the Cats Paw device at the introductory meeting. According to Questionnaire #1: (please see sample)

Participants were separated into 3 categories:

Group A. Experience discomfort and have sought medical attention.
Group B. Experience discomfort but have not sought medical attention.
Group C. Experience NO discomfort but want to participate preventatively.

Participants were asked to:
a) Name the type of symptoms they were experiencing from the supplied list of 8 common CTS symptoms listed on questionnaire #1.

b) Rate the severity of each symptom on a scale of 1 (incapacitating) to 5 (none).

c) Name the location of their discomfort.

d) Describe when and for how long each day particular symptoms occur, i.e. numbness at night - wakes me up 2 times per night.

e) Current and past types of therapies utilized from a list of typical therapies.
Participants were also asked their job titles and to describe their job duties, outside of work hobbies and activities for possible contributing factors and to check any current treatments they were using from a list of common treatment options.

After completing Questionnaire #1 at the introductory meetings and signing the Cats Paw Trial Agreement, participants were instructed in the proper use of the Cats Paw and given Log Sheets to record daily use. At each meeting a conservative start to the recommended routine of 2 sets of 20 reps was stressed, especially for people in Group A, the most seriously affected.

We were not able to use electronic mail orin-house cc mail weekly reminders and comment requests in this study as we did in Trial #1 because many (over 2/3) of the participants’ computers did not have this capability.

Questionnaire #2 (post trial) was sent out to all participants on 2-8-96 with a copy of their original pre-trial Questionnaire #1. Participants were asked to subjectively re-evaluate their condition/symptoms on the same 1 to 5 scale.

DATA

Group A - Experience discomfort and have sought medical assistance.

3 employees

In this group the Cats Paw was the least effective. As we saw in the first study, the more serious the symptoms, the less the chances are that the Cats Paw will be effective.

Out of 3 - 1 reported slight improvement, 1 reported minor relief, and the last 1 reported an increase in discomfort and discontinued use. 2 of 3 would recommend the Cats Paw.

Comments: "My symptoms improved, I believe it is a beneficial long-term treatment tool."

Group B - Have discomfort but have not sought medical assistance.

23 employees As in the first study, the Cats Paw proved to be the most effective with this group.

65% reported symptoms reduced or eliminated and 74% would recommend the Cats Paw. 9 subjects reported substantial improvement or elimination of their symptoms, 6 reported slight improvement, 5 reported no difference and 3 reported some increased discomfort and discontinued use.

17 out of 23 - 74% would recommend the Cats Paw.

Comments" "When I used the Cats Paw the pain actually went away - if I stopped for a few days it would come back." Mary Jane Anderson "In the past when I worked on the PC a lot, I would occasionally suffer tingling in my fingers. That has not happened with using the Cats Paw."

Ken Cado "It works great, discomfort is gone." Johnny La

Group C - Have no discomfort but am participant as a preventative measure 9 employees

This group was participating preventatively, no one had any current symptoms. All reported no problems developed, 6 would recommend Cats Paw, 3 had no opinion.

Comments: "They didn’t hurt when I started and they don’t hurt now." Christine Baker

"I would recommend using the Cats Paw because it feels good - I think it prevents problems." Linda Tufts

DISCUSSION

Data compiled in this second Cats Paw Trial supports all previous testing data. In this study using the Cats Paw hand exerciser and prescribed exercise routine reduced or eliminated the primary symptoms of RSI and specifically Carpal Tunnel Syndrome for 68% of responding trial participants. In the first SCL Cats Paw Trial, 66% reported relief.

Also, using the Cats Paw preventatively with employees without problems, but in high risk positions (heavy PC users) did not cause the development of any type of CTS related symptoms. These data support the previous findings that employing this device and technique is most beneficial before an employee develops so great a problem that they require medical attention.

A preventative program using the Cats Paw will reduce case instances. The problem in developing an efficient preventative program is making sure the program is carried out by employees. The Cats Paw Screen Saver was created by the manufacturer to address this exact question. Installing the Screen Saver with programmable break reminder will promote awareness and instruct the use of the Cats Paw device.

How many employees experiencing discomfort, or that listed primary symptoms, will digress to develop a compensatable or debilitating case of RSI or CTS is speculation. However, by eliminating symptoms or reducing symptom severity in over 60% of employees experiencing discomfort we are taking a tremendous step toward controlling this problem and keeping it from getting worse. According to the cost analysis, we can supply all 2000 SCL employees with a Cats Paw for less than the cost of one compensatable Carpal Tunnel case.

According to Drs. Silverstein, Fine and Armstrong of the Occupational Health Program at the University of Michigan, "a classic framework of preventative measures, including a conditioning process which increases worker tolerance, should reduce the number and severity of cases of CTS.

" The Cats Paw addresses the problem of repetitive strain by conditioning the opposing muscle groups of the ones that are constantly used. With no opposing muscle exercise a biomechanical imbalance is created which leads to those types of problems. This argument is supported by Dr. Emil Pascarelli, who says, "You must do exercises to strengthen corresponding muscle groups faithfully to keep everything in balance and remain in shape for your job." Dr. Pascarelli is an expert on RSI at the Miller Institute at Columbia University and author of the book RSI, a Computer Users’ Guide.

An interesting fact to mention here is the psychological effect of the Cats Paw. It is a very common sense approach and device that most people can easily understand and it makes sense to them. This puts them into a positive frame of mind and thus, they are more likely to use it, follow through, and being in a positive frame of mind are more likely to see positive results.

Initiating company-wide use of this patented exercise product and program makes financial sense and is a small investment in employee health. It is not a "cure all" but it is an easy and effective addition to our overall ergonomic efforts, much like the back brace has been for many companies.

In my opinion, the Cats Paw is a simple, affordable and effective tool that will help save SCL money and SCL employees needless suffering.

May 15, 1997

To whom it may concern:

In the summer of 1996 the Denver Orthopedic Specialists had the pleasure of being part of a test for the "Cats Paw." We have over 40 employees in our central business office that participated. The majority of our staff is in use of a computer terminal for either the majority, if not the entire day. In the preliminary pole taken, we found many to have substantial signs of the onset of carpal tunnel syndrome or similar ailments. Through the daily use of the "Cats Paw", we found our staff to have significant reduction in symptoms and at times complete relief from their ailments. We saw an increase in staff productivity in a short amount of time after the implementation of the "Cats Paw" as a daily exercise.

The "Cats Paw" is extremely user friendly, simplistic in design yet very effective and I would highly recommend it to anyone in a profession where repetitive motion is a daily occurrence. With the current magnitude of workers’ compensation claims for this type of ailment, the use of a product such as the "Cats Paw" is a must for any corporation large or small.

If you have any further questions, I’d be happy to address them.

Kelly Jackson

Denver Orthopedic Specialists, P.C.
2305 So. Colorado Blvd.,
Suite 100,
Denver, CO 80222

PUBLIC UTILITY DISTRICT OF GRANT COUNTY, WASHINGTON MEMORANDUM TO:

All Cats Paw Users

VIA: Marv Scott, Safety & Health Coordinator

FROM: Shane P. Heston, Safety & Training

SUBJECT: Cats Paw Carpal Tunnel Hand Exerciser

Discussion: During the past several months the Safety Department has been receiving inquiries about methods to prevent Carpal Tunnel Syndrome (CTS) and other repetitive motion disorders.

The Safety Department has researched several different types of hand exercisers and stretchers. Up until this point their has not been any success, mainly because all of the exercisers involved squeezing and gripping. However the device we have been testing recently does not involve squeezing or gripping, but strengthening the extensor (opening) muscles of your hand and arm. This device is called the "Cats Paw".

We recently completed a 3 week case study of PUD employees using the Cats Paw. The results show that the Cats Paw hand exerciser is of benefit to employees. Therefore, the Safety Department is issuing Cats Paws to employees to aid in the prevention of Carpal Tunnel Syndrome.

Please contact the Safety Department if you have any questions or concerns. Remember an ounce of prevention is worth a pound of cure.

SPH

Study Questions Use of Wrist Braces

By Lore Croghan, Knight-Ridder News Service

Corporate America sees wrist braces as a cheap way to solve the expensive problem of repetitive wrist strain. They’re making a big mistake, a new study says.

Ninety-two percent of America’s industrial and service companies recommend wrist braces to alleviate workers’ wrist pain—but the braces may do little good or actually cause harm, says a survey released Monday by the Center for Workplace Health in Haverford, PA. In contrast, it says, only 30 percent of occupational-health-care providers recommend the use of wrist braces.

"Companies are desperate to deal with this problem," James Kinsella, editor of monthly newsletter CTDNews, said. "Braces seem to provide a solution, at least temporarily," Kinsella said. ""What health professionals are saying is that it’s no solution.

When you’re temporarily taking away the pain, you’re drawing attention away from the problem." The Center for Workplace Health publishes CTDNews. The acronym stands for Cumulative Trauma Disorders, of which repetitive wrist injury is one. Kinsella said he was surprised at how widely wrist braces are used to fight pain caused by workplace injury. Wrist braces are rigid wraps made of plastic, leather or metal that fit over the bottom of the hand and the back of the upper arm. They hold the wrist straight when moved.

They typically cost between $20 and $30. Made by a number of manufacturers, they are widely available at medical-supply stores. One company plans to begin selling them in grocery stores, Kinsella said. Wrist pain affects millions of workers nationwide. They work in computer data-processing such as travel agencies, telemarketing or newspapers, or in manufacturing, construction and food processing.

Specifically, 1.89 million Americans suffer symptoms of the repetitive-strain wrist injury known as carpal tunnel syndrome, according to a CTDNews survey conducted last fall. And another 4 million American workers have tendonitis, many of them in their wrists and arms.

The care of the injured costs companies a bundle, Kinsella said. He cites a recent report from Blue Cross of California estimating the total price tag for the average carpal tunnel case as $100,000, including medical expenses and lost productivity.

Kinsella does not expect the survey to slow the sale of wrist braces. He hopes, instead, that it will make people think about taking better care of themselves at work.

"I hope it makes workers more educated about the pain they’re feeling and realize that wrist braces aren’t the only solution," Kinsella said.

Ray Anchan,

Seattle City Light Facilities Manager

September 22, 1994

Gibney International
CATS PAW
Santa Barbara, CA 93109

Dear Mr. Gibney:

Thank you, thank you, thank you for inventing and developing the "Cats Paw" for people with repetitive motion injuries in the hand. I work for Seattle City Light and understand that our Safety & Health Specialist, Kevin Mosley, has been in touch with you about my success with this device and my recommendation for the Utility to issue these to all PC users.

Rather than send you another testimonial about my results, I am sending you a copy of the suggestion I submitted to our Safety and Health unit. Feel free to quote me on anything I said in that suggestion – it is all factual.

PROJECTED IMPROVEMENT: My condition has improved over 200% in just the past two weeks and I guarantee you that I will continue to use this device every night. In addition, I have been able to reduce dramatically the amount of pain reliever I take every day. I estimate that most people currently suffering from this problem will experience major improvement and thus reduce their personal medical costs as well as cost to the City and its insurance carriers. Not to mention the reduction in lost time to the City and SCL but hopefully an increase in productivity as well.

MONETARY BENEFITS: Assuming the numbers stated above are close to accurate, the potential savings to SCL, the City, its insurance carriers, etc. is astronomical:

1,000 employees X $5,000 avg. cost per, equals $5,000,000 (note that’s million not thousand)

1,000 Cats Paw devices X $8.50 equals $8,500.

Assuming that these numbers are off by as much as 50% (which I doubt) the potential savings, considering some level of continued medial treatment, therapy, etc. is still over a million dollars, not counting the savings from a reduction in lost work time and increased productivity.

Also, although a nominal cost, I’m sure that if these devices were purchased in bulk (large quantities) that the cost per device would be considerably less than $8.50. 500 employees X $2,500 avg. cost per, equals $1,250,000

Exactly how much of this savings can be attributed to the first year – I’m not sure. But whatever the case, I’m certain if you do some research and calculate a few numbers, you will find the savings to be quite significant. We all know that CPS is a serious injury and on the increase in today’s modern office environment. Why not take a couple hundred dollars out of your budget, buy a quantity of these devices, give them to known persons suffering from CPS, and measure the results.

I believe that you will find, as I did, that the results are dramatic. Then, when convinced, why not issue one with each PC. Who knows, this could be to the age of technology what the hard hat has been to the construction work force.

Ray Anchan

May 16, 1997

Joel Gibney,
Gibney International

Dear Joel:

I am happy to supply you with this letter concerning our positive experiences with your product, the Cats Paw Ergonomic Hand Exerciser.

After receiving your samples, we started using them at some companies having trouble with Carpal Tunnel Syndrome. Results have been good; we have seen a reduction in the number of Carpal Tunnel type problems and claims.

We specialize in workers’ compensation insurance and have seen many products. The Cats Paw seems to be working better than anything else we have found for reducing Carpal Tunnel Syndrome claims for our clients.

Most of our clients who passed out Cats Paws have been impressed with the results and are requesting more. I would recommend the Cats Paw to any company concerned with Carpal Tunnel or Repetitive Strain. We will continue to recommend and use your effective and affordable product.

Sincerely,

Thomas Steinbrenner,
Ogilvy, Gilbert, Norris & Hill Insurance

The Seattle Times

Wrist Splints may do more harm than good, says research team

Flexible wrist splints are not effective in preventing Carpal Tunnel Syndrome and may do some people more harm than good, according to the first study of the popular devices.

Researchers at the University of California, San Francisco, and the University of Washington tested the splints in 19 volunteers who did not have Carpal Tunnel syndrome.

They were asked to wear the splints while loading and unloading 20 1-pound cans from a box for 5 minutes. The scientists found that the activity of their hands increased the pressure in the Carpal Tunnel, both with and without the splints, thus putting the volunteers at greater risk for Carpal Tunnel Syndrome.

Carpal Tunnel is an occupational illness that results from stress on the median nerve, which is housed in the Carpal Tunnel, the tiny channel in the hand and wrist.

Patients initially experience pain and tingling and ultimately may lose sensation and use of the hand altogether. "Basically, the study shows the splint has no value in reducing carpal tunnel pressure and may increase the risk in some people," said Dr. David Remple, lead author of the study, which was published in the January issue of the Journal of Hand Surgery.

---From staff and wire reports

TO ORDER or for information on LOGO and BUNDLING PROGRAMS call GIBNEY INTERNATIONAL @ 1-800-CATSPAW (1-800-228-7729)
info@catspaw.com

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