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October   2 4  -   2 5 2017 October   2 4  -   2 5 2017

October 2 4 - 2 5 2017 - PowerPoint Presentation

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Uploaded On 2018-09-30

October 2 4 - 2 5 2017 - PPT Presentation

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

physical work hardening functional work physical functional hardening return fce phase capacity therapy job program industrial development components conditioning

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Presentation Transcript

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

14Slide15

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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