Located at the Greater Richmond Convention Center Getting Back To Work Presented By Darla J Croce RKT CWT REHAB AT WORK Director of Business Development Physical Therapy Industrial Rehabilitation ID: 682694
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Slide1
October
2
4 - 25 2017
Located at the Greater Richmond Convention CenterSlide2
Getting Back To Work
Presented
By
:Darla J. Croce RKT, CWTREHAB AT WORK, Director of Business DevelopmentSlide3
Physical Therapy
Industrial Rehabilitation
Functional Capacity Evaluations
Work Hardening/Work ConditioningUsing Physical Medicine Services to RTWSlide4
4
Industrial Rehabilitation:
FCE Work Hardening/Work ConditioningChronic Phase (3 months or longer) Physical TherapyAcute Phase (1 - 3 weeks)
Sub-Acute Phase (4 – 12 weeksTimeline to Refer for Service
Fun Facts:
75% of injured workers return to work with the Acute Phase
80% of injured workers return to work within the Sub-Acute Phase
90% of injured workers return to work within the Chronic PhaseSlide5
5
Functional Capacity
Evaluate current functional
capabilitesJob modifications for RTWCompare capabilities vs. job descriptionAssess symptom management skillsAdvance once plateau in PT
Physical TherapyAfter an acute injury Pre or Post surgeryIncrease range of motion and or strength
When to Refer for Service
Work Hardening/Conditioning
Decrease functional deficits
Work on consistency of effort issues
Increase workplace tolerance
Document and improve worker behaviors
Establish physical demand levelSlide6
Hierarchy of Return to WorkSame Job Same Employer
Different Job Same EmployerSame Job Different EmployerDifferent Job Different EmployerSlide7
Components of Physical TherapyPhysical therapy uses mechanical force and movements [Bio-mechanics or Kinesiology], Manual therapy, exercise therapy, electrotherapy and various physical therapies who practice evidence based treatments, remediates impairments and promotes mobility, function, and quality of life through examination, diagnosis, prognosis, and physical intervention. Slide8
What to look for:1. Objective, measurable goals2. Progression in range of motion, strength, and progressive resistant exercises
Increase in functional activitiesDecrease in passive modalities
Home exercise programSlide9
Expected Outcomes from Physical Therapy
Return to Work Full DutyReturn to Work Modified Duty
Refer for Functional Capacity Evaluation
Needs further Medical InterventionSlide10
Definitions of a FCE:
A FCE incorporates a comprehensive neuromusculoskeletal examination with measurements of physical impairment, symptom magnification, worker behaviors, and function and culminates with the measurement of the current functional abilities of the client*
*
According to Development of Clinical Standards in Industrial RehabilitationA Functional Capacity Evaluation (FCE) is a “comprehensive battery of performance based tests that are commonly used to determine ability for work, activities of daily living or leisure activities”.* * As defined by the APTASlide11
Components of FCE
Musculoskeletal Findings
FLEXIBILITY: measured using AMA recommendations in degrees active/passive
STRENGTH: manual muscle grades 0 to 5 5 = excellent4 = good3 = fair2 = poor1 = trace
OTHER: reflexes, sensation, special tests, etc.8/4/2017
11Slide12
Components of FCE
FUNCTIONALPHYSICAL DEMAND CATEGORY
VERY HEAVY >
HEAVY > MEDIUM > LIGHT > SEDENTARYFUNCTIONAL DEFICITSforces vs. tolerancesjob specificWORKPLACE TOLERANCE8/4/2017
12Slide13
Functional TestingNon- Material Handling
Sit Stand
Walk
Squat/CrouchBend/StoopClimb StairsReachCrawlKneelBalanceMaterial Handling
LiftingFloor to WaistKnee to WaistWaist to ShoulderWaist to Overhead
CarryPush/PullJob Specific TestingSlide14
Components of FCE
Worker BehaviorsSYMPTOM MANAGEMENTGood, Fair, or Poor
Consistency of Effort
Reliability of pain and disability reports Illness behaviorPhysical effort during testWORKER TRAITSPsychosocial SkillsWorker BehaviorsInterpersonal skills
8/4/2017
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Expected Outcomes from a Functional Capacity Evaluation
Return to Work Full DutyReturn to Work Permanent Modified Duty
Case Closure
Need for Physical TherapyRefer to Work Site ServicesWork Hardening or Work Conditioning ProgramSlide16
Definitions of Work Hardening/Work Conditioning
Work Conditioningis a “work related, intensive, and goal-oriented treatment program designed to restore an individuals systemic, neuro-muscular (strength, endurance, movement, flexibility, and motor control) and cardiopulmonary functions”.*
Work Hardening is “a highly structured, goal-oriented, individualized intervention program designed to return the person to work’’.* It utilizes real or simulated work activities designed to restore physical, behavioral, and vocational function.*
*According: Development of Clinical Standards in Industrial RehabilitationSlide17
Componenets of Work Hardening/Conditiong
Musculoskeletal programRange of motion
Strengthening program
Cardiovascular enduranceFunctional programJob specific work simulationWork simulation based off of functional deficitsIncrease workplace tolerance Worker behaviorAccountabilityTimeliness
Symptom managementConsistency of performanceSlide18
Expected Outcomes from Work Hardening or Work Conditioning
Return to Work Full DutyReturn to Work Permanent Modified Duty
Needs further Medical Intervention
Case ClosureRefer for Work Site ServicesSlide19
Wrap UP
Thank you for your time QuestionsSlide20
Darla J. Croce RKT, CWTRegistered
KinesiotherapistDirector of Business Development
Phone:
301-838-2040darlac@rehabatwork.comVirginia Workers’ Compensation Commission1000 DMV
DriveRichmond, Virginia 23220877-664-2566
│ questions@workcomp.virginia.gov │
workcomp.virginia.gov
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