return to work Flashcards
sedentary work
OCCASIONALLY: 10 lbs
FREQUENTLY: negligible force to lift, carry, push, pull objects
- sitting mostly
- may walk/stand briefly
light work
OCCASIONALLY: 20 lbs
FREQUENTLY: 10 lbs
CONSTANTLY: negligible force to lift, carry, push, pull objects
- walking/standing significantly
- sitting mostly but pushing/pulling arm or leg controls
medium work
OCCASIONALLY: 20-50 lbs
FREQUENTLY: 10-25 lbs
CONSTANTLY: more than negligible to 10 lbs
heavy work
OCCASIONALLY: 50-100 lbs
FREQUENTLY: 25-50 lbs
CONSTANTLY: 10-20 lbs
very heavy work
OCCASIONALLY: 100 lbs +
FREQUENTLY: 50 lbs
CONSTANTLY: 20 lbs
frequency of work tasks
never: does not exist
occasional: occurs 1/3 of the day
frequent: occurs 1/3-2/3 of the day
constant: occurs 2/3 of the day
ergonomic interventions at the workplace
administration controls, work practice controls, engineering controls
how to prevent repetitive injury/muscle strain
frequent stretch breaks, movement away from static posture
primary injury prevention
- healthy individuals
- no injury
- worksite evaluation, ergonomic intervention/training
EX: educational program for ergonomics, promote better positioning at work through modifications and weight belts
secondary injury prevention
- at risk for injury
- early detection
- prevent
EX: adapting the home of a man recovering from a THR
tertiary injury prevention
- already affected
- nonreversible injury requiring intervention
EX: water exercise program for people with MS
vocational evaluation
info about individual capabilities/interests for new work situations/seeking new work
core of all return to work programs
functional capacity evaluation (FCE)
what does a FCE include?
job demands analysis
FCE
objective assessment of person’s ability to perform work-related tasks (include worker’s limitations)
- assess physical demands of work as defined by O*NET (can refer to employer-provided job description)
- review med records
- interview
- musculoskeletal screening
- evaluate physical performance
- make recommendations
- generate report
Labor’s O*NET
source of job demands, requirements, characteristics for all job classifications
work hardening
structured, biomechanical/remedial approach
-interdisciplinary
- actual task replication
- individualized & outcomes focused
- work simulation & conditioning exercises to increase strength/endurance in work-related skills
- adapted work activities & grading activities (hierarchy of functional return)
freq: 5 days a week (add an hr each week until reaching 8 hrs)
Week 1: 4 hrs
Week 2: 5 hrs
Week 3: 6 hrs
what is an interdisciplinary approach to work rehab?
work hardening
what is a biomechanical work rehab approach?
work hardening, work conditioning
what is an adjunct to work hardening?
vocational retraining
work conditioning
restore neuromusculoskeletal function, return to work, limited work tasks, exercise, aerobic conditioning, education
- BEFORE work hardening
- only 1 discipline
- nonspecific, job simulated tasks (carrying, pushing, pulling), strengthen muscles specific to job tasks
- monitor for overexertion/fatigue, adjust program
- frequency: 1-3hrs a day, 5 days per week, 1-3 months
order of work rehab programs
work conditioning –> work hardening
work rehab that focuses on 1 discipline
work conditioning
light or modified duty programming
- temporary less physical demands at work, gradual add on of duties
- advocate for early return to work
- designated staff trained to monitor workers adjustment/tolerance to work tasks
- work with employer for workplace mods, maintain in productive work capacity during progressive recovery
work readiness progrm
- help worker identify work goals, plan return after serious illness/injury
- if unable to return, help come up with work options to match interests, skills, abilities
job accomodations
cooperation between worker, OT, employer
- alter duty/schedule
- modify facility
- AE, assistive tech
- modify/design new product
job demands analysis
- defines actual job demands in real work environment
- questionnaires, interview, observation, formal assessment
- uses employer-provided job descriptions
- included in FCE
- essential vs nonessential tasks
work tolerance screening
- assess physical and cognitive abilities to meet job demands
- client factors (strength, balance), activity demands (weight, distance)
- can they perform job tasks?
- AFTER job offer
- revoke offer or another job if not passing
which work rehab program assesses cognitive abilities?
work tolerance screening
when is work tolerance screening completed?
after job is offered
vocational rehab programs
- state/federal operation
- job training/placement for those with disabilities
- Maximize levels of function following injury and/or illness to maintain a desired quality of life for the worker.
- Remediate and/or prevent future injury or illness.
- Prevent the negative psychosocial consequences of unemployment
work simulator
- electromechanical isotonic & isometric device
- for work eval & intervention to improve functional abilities
return to work program
- work rehab continuum
- promotes cost-effective steps goal completion at work
modification of work environment, workstation, setup without AD is
engineering controls
examples of engineering controls
- workstation height
- good working positions
- workstation components
- chair characteristics
examples of administrative controls
- job rotation through different workstations
- changes in line speed, staffing, physical demands
- periodic rest breaks
- PPE
- equipment to prevent heavy lifting
what involves improving safe performance of work tasks?
work practice controls
work practice controls examples
- factory wide stretching
- body mechanics training
- selection/use of PPE
- modification of work processes
what are the checklists for combating ergonomic risk factors?
- state of wisconsin department of administration
- Haruko Ha et al
what involves understanding the organization’s culture with an incentive system?
empowering corporate clients (teamwork environment)
transitional employment program
- support at a pre-arranged job site on a temporary basis
- when client has shown that he can perform the job on his own without the additional support, the transitional employment program will end and client will maintain employment on his own
supported employment
support/assistance at a pre-arranged job site permanently
what is included in an FCE?
- Functional testing (graded material-handling activities such as lifting, carrying, pushing, and pulling)
- positional tolerance activities (sitting, standing, walking, balancing, reaching, stooping, kneeling, crouching, crawling, object handling/manipulation, hand grasping, and hand manipulation)
- pain monitoring
- evaluation of endurance
If a client needs work adaptations, are they expected to purchase them themselves?
No, the employer is expected to do so, unless it results in undue hardship
Prevocational training
Prepare for competitive employment
- gov funded
- improves skills in: social, tasks, habits, abilities
- prepare for discharge to vocational training, school, or work
- offered at sheltered employment, in house jobs, TEPs
Sheltered employment
For disabled
- supervision provided
- separate environment from usual work site
- paid below min wage
In house jobs
- day treatment
- clubhouse model (which can include TEP work)
