RTW Flashcards
RTW Planning
ϑ Goal is always to restore function/RTW
ϑ Quicker they get back to the workplace the better (in some function)
ϑ After 20 days off there is a 70% chance they will ever RTW (70days= 35%)
Steps in Preparing RTW
- Understand Prognosis/functional limitations
- Understand the physical demands of the job
- Match the Worker with suitable tasks/exercise
Steps in Preparing RTW
1. Understand Prognosis/functional limitations
• Review medical reports, certificates, treatment plans. • Expected recovery times/ • Barriers: ϑ Limited knowledge ϑ Feelings of reduced worth ϑ Repercussions from workplace ϑ Fear of re-injury ϑ Lack of flexibility in work tasks • Asses via interviewing, multidimensional scales (Orebro) and uni-dimensional scales (TAMPA)
Steps in Preparing RTW
2. Understand the physical demands of the job
a. Subjective examination, go to work place and Job Requirements and Physical Demand scale/self-report tool
Steps in Preparing RTW
3. Match the Worker with suitable tasks/exercise
a. Must still make them valuable but also within medical certificate restrictions
i. Suitable Duties Plan
b. You must disclose your injury to the employer if it is to effect your work
i. If injury not acquired at work don’t have to
Physios Role IN RTW ***
♣ Outcome focused and goal orientated services to achieve max function/RTW
♣ Advise and liaise with MDT (insurer)
♣ Keep detailed, up to date notes
♣ Provider may require a management plan >5 sessions (in QLD this isn’t paid for)
FCE
ϑ Systematic approach to measuring, recording and analysing an individual’s ability to perform activities in response to broad work demands.
ϑ Assesses capacity, not willingness to perform
Why is FCE performed?
ϑ RTW ϑ Pre-employment ϑ Rehab planning ϑ Medico-legal ϑ Ongoing risk management
Stages of FCE:
- Preparation:
- Execution:
- Report writing - match findings with work demands
Stages of FCE:
• Preparation:
o Gather medical reports, job analysis, progress reports (rehab providers).
o Authority to exchange information
o Informed consent
• Execution:
o Patient interview
o Objective Ax > neuromuscular/physical screen, Fx testing, work-specific.
o Safety considerations
o Post-test symptoms
Signs of Fatigue
ϑ Slower pace ϑ Accessory muscle use ϑ Trembling ϑ Using your body to slide the load down ϑ Load is controlling the client
Stop FCE assessment
if physiological limits (HR>85%/70% for beta blockers),
- physical indicators OF FATIGUE and psychological limits (client thinks not if the clients behaviours indicate they are in pain)
FCE OUTCOMES
⎦ Chronic pain has been shown to create significant barriers in predicting RTW
⎦ Better performance associated with higher risk of reoccurrence
