Although work conditioning is commonly mistaken as a continuation of physical therapy, it is actually a separate entity. Work conditioning by definition is an intensive goal-oriented treatment program that is structured to allow injured workers to regain their strength, endurance, and confidence in order to return to work. Patients are usually referred to an outpatient therapy clinic immediately after surgery for a few days per week at 30-minute to hour-long sessions. At the end of the visits, the patients will have improved their strength and flexibility but may still not meet the physical demands of their regular jobs. For example, a patient with a knee injury may learn to walk without assistance, but it does not necessarily mean that he has the strength to lift a keg or the balance to maneuver sheets of drywall.
Our work conditioning program bridges the gap between outpatient therapy and the physical demands of the job once the worker is medically stable. Patients begin with 2-hour sessions and gradually progress to 4-hour sessions for 5 days a week. During the initial visit, the patient will be assessed including a baseline musculoskeletal exam, dynamic lifting, repetitive movement, sustained postural tolerance, and, if necessary, cross-reference validity testing. All of the information is gathered in a report that is shared with the referring physician, case manager, and adjuster. The information is also used as a baseline to determine gains or losses throughout the program.
At Job Ready Services, an individualized program is structured for each patient to increase strength and flexibility that are specific to their jobs. The principle of specificity states that “the closer the training routine is to the requirements of the desired outcomes, the better will be the outcome.”1 We believe that we have an advantage in providing job specific exercises because we are also provide post-offer employment testing that requires we have thousands of Job Specific Tasks that can be incorporated into the rehab process. Even if an employer is unable to provide an adequate job description, we will have hundreds of job analyses on file at our fingertips to provide job specific tasks unique to each occupation. We can also access an exclusive online database for even more job specific tasks. Another advantage is that we incorporate job-specific equipment that are used on job sites, such as concrete chutes, plywood, and ladders. A patient may be able to carry an 80-lb box or lift 80 lbs on a workout machine, however, he will find that being able to handle an 80-lb piece of plywood is much more challenging. Our staff is able to identify job specific tasks and materials that most closely mimic the activities that the patient must do in order to be released back to work safely.
As the patients work towards being able to accomplish the job specific tasks, we will provide a re-evaluation report every 10 visits to monitor progress and decide whether the goals are met. The information can also be used as further documentation of non-compliance for a patient that has not been giving a fair effort in the program. Our statistics show that a referred patient will attend an average of 16 visits. At that time, patients are either recommended to go back to full duty or modified duty. Those who were not able to meet the physical demands for full or modified duty now have objective evidence of their current physical abilities.
Most importantly, the majority of patients will finish the program, return to work, and have a positive experience. One patient said “work conditioning was good to show me that I had more strength than I had believed…overall I am ready to move on and confident that I can continue to improve on my own.” Another patient had only one complaint about her experience: “I wish this had been suggested after release from PT last June! Don’t understand why it wasn’t!” Don’t hesitate if you think that your patients would benefit from our work conditioning program. The earlier the referral, the better the outcome. We welcome “brainstorming” calls too! We will be glad to discuss a case with you to determine whether work conditioning or other services might be of benefit. Please contact Job Ready Services at (919)256-1400 or firstname.lastname@example.org to learn more.
– Submitted by Vincent Nieh, Work Conditioning Coordinator
1Hawley, John A. “Specificity of training adaptation: time for a rethink?” The Journal of Physiology 586.1 (2008): 1-2.