Occupational Rehabilitation & Return To Work Programming Flashcards
Transition services involve
Preparing adolescents & young adults with special needs for work
OT vs OTA role in work rehab settings
OTA: provides verbal & written reports to OT in eval process, carry out intervention according to OTs plan
OT: completes initial eval report, develops intervention plan
Both: collaborate to meet client’s needs & carry out OT process
OTs as educators
- Identify who is affected at work (age, gender, skill level, general health)
- Facilitate learning for clients
- Implement strategies according to client’s learning styles
Aim of injury prevention programs
Decrease employers costs related to work injuries, improve worker fitness/safety, unite employers & workers to improve workplace safety
Reimbursement sources for services
- Vocational rehab
- Private medical insurance
- Employer or organization direct payment
- Government funding
ADA
Americans with Disabilities Act
- accommodate those with disabilities
OSHA
Occupational Safety and Health Administration
- safe & healthful working conditions
- set standards
- provide training, outreach, education, assistance
- ergonomics guidelines for lifting & reducing work injuries
NIOSH
National Institute for Occupational Safety and Health (part of CDC)
- conducts research and makes recommendations to prevent work injury/illness
- info about work safety and health: injury, hazards, prevention, ergonomics
O*NET
Occupational Information Network (part of US Dept of Labor, Employment, & Training Admin)
- database of job requirements, worker attributes, info about occupations that are helpful when documenting job demands
- replaced Dictionary of Occupational Titles
EEOC
Equal Employment Opportunity Commission (part of Uniform Guidelines on Employee Selection Procedures)
- employee selection is fair
- applies to new employees, those returning to work after injury/illness, those with disabilities
Work-related musculoskeletal disorders (WMSDs)
Soft tissue injuries affecting muscles, tendons, nerves
- slow, insidious onset
- result of micro trauma
- 1/3 of all occupation injuries/illnesses in US
Common types of WMSDs
- back injuries
- carpal tunnel syndrome
- deQyervain’s tenosynovitis
- lateral epicondylitis
Factors increasing WMSD risk
- lifting heavy material
- poor workstation design
- poor work process design
Is a fall considered a musculoskeletal disorder per US Dept of Labor?
No
Back & neck rehab training
- strategies to improve fitness, job comfort, workplace safety to prevent injury, retrain after injury
- actual or simulated job tasks
- can assess body mechanics through checklists but not to determine actual body movements (no reliability or validity, not sensitive to changes in performance)
- assess for ergonomic risk factors (forceful exertions, repetition, awkward/static posturing, contact stress, excess vibration, cold temps)
- provide ergonomic strategies
Body mechanics & postural alignment strategies
- Spine aligned
- Objects close to center of gravity
- Avoid twisting spine
- Both sides of body equally, maintain wide base of support
Improving environmental fit by
Changes to work environment
- workstation modif
- proper tool access/fit
- proper materials handling
- adjustments to environmental factors (temp, lighting)
Cognitive behavioral strategies
- positive reinforcement
- progressive relaxation
- biofeedback
What considers psychosocial needs of clients and physical deficits
Holistic & client-centered approach
Symptom magnification
- non adaptive, static approach to manipulating society with display of symptoms
- consistency of effort, sincerity of effort, max voluntary effort
- unconscious & conscious behavior
Malingering
Deliberate or conscious faking of symptoms/disability to achieve personal gain
3 types of symptom magnification
- Refugee/somatoform disorder
- Game player/malingerer
- Identified patient/chronic fictitious disorder
Refugee/somatoform disorder
Uses symptoms to escape unresolvable conflict or situation
Game player/malingerer
Consciously attempts to convince other works of the reality of symptoms for positive gain
Identified patient/chronic factitious disorder
Person assumes patient role as lifestyle
Symptom minimizer
Keeps symptoms hidden so they can return to normal activity and not appear weak
Symptom mininterpreter
Responds to physical changes to body in extreme manner due to difficulty processing sensory & kinesthetic input or unrealistic belief systems about manner in which body works
What is a required part of functional capacity evaluation (FCE)?
Identification of symptom magnification
What is a common assessment used to assist the clinician in determining max effort
Five level grip test (uses dynamometer)
- client to grasp it at each setting handle
- strongest grip expected on 2nd and 3rd settings
- results graphed & expected to fall in bell-shaped curve
4 characteristics for implementation of successful work injury prevention program
- Ongoing management support
- Supervisory support
- Employee participation
- Ongoing support & reinforcement of the programs
Steps to implement injury prevention program
- Corporate plan
- Injury prevention team
- Training for risk factor identification
- Ergonomic eval
- Developing risk factor controls
- Implementing med management strategies (early intervention, transitional work/modified duty programs)
Primary prevention
Identify/reduce risk factors early before injuries occur & promote healthy work habits/lifestyle
Secondary prevention
Early identification of symptom related risk factors to minimize/reduce duration, severity, cost of work-related injuries
Tertiary prevention
Occurs after injury/illness dx
- medically treating work-related injury, restoring work role
Job demands analysis
Defines actual demands of a job
- questionnaires, interviews, observations, formal assessments in real work environment
- distinguish between necessary tasks and unnecessary tasks