This 3 hour group educational program teaches clients how to lead an active life while effectively managing their back symptoms.

Our trained therapy staff provides instruction in basic anatomy of the spine and common causes of back injury. We teach effective strategies for managing specific back conditions and symptoms and for promoting healing following a back injury. 

Clients actively participate in a body mechanics and posture training session. This information is then used to identify back protection strategies for specific domestic and work activities. Adaptive equipment designed to reduce stress on the back is demonstrated and clients are provided with an opportunity to practice new techniques and equipment.

We stress the importance of client responsibility for recovery from an injury and provide the knowledge and strategies necessary for preventing re-injuries.

Ergonomics is the science of fitting the job to the worker. It facilitates maximum productivity, consistent quality, and long-term worker health and safety by acknowledging, identifying, and reducing or eliminating ergonomic risk factors which pose biomechanical stresses (force, repetition, awkward postures, static positions, contact stress, vibration, and cold temperatures) to the worker. A well-designed workstation improves human performance by eliminating excessive, non-productive motions and thereby improving worker efficiency and cycle times. This translates into increased productivity and increased profit margins.

By investing in a more efficient process, industries also invest in a healthier workforce. This means decreased worker's compensation costs, lost time injuries and retraining/replacement expenses.

A specially trained physical or occupational therapist conducts an on-site assessment of work activities, identifies risk factors, makes recommendations for controls, and re-evaluates the effectiveness of changes implemented.

We generate a comprehensive report that provides a focus for improving ergonomics, developing an ergonomics program, and decreasing risk factors in your company's work environment.

A Functional Capacity Evaluation is a comprehensive, objective testing of a worker's ability to do work-related tasks. Our Performance Center staff is specially trained in the Isernhagen Work Systems Functional Capacity Evaluation. We offer the most objective musculoskeletally oriented assessment in the area. Our functional capacity evaluation is based on internationally accepted principles used by physical and occupational therapists to identify abilities and limitations of an injured worker.

What does this mean for you?

• You will receive information regarding return to work physical abilities explained in very clear, objective language.
• You will be able to determine if the physical abilities of the worker allow return to work, indicate that rehabilitation (work hardening) would be of assistance, or require a job-site modification.
• The information provided is objective, describing the worker at the highest level of productivity based on physical strength and endurance. The test is not restricted by self-imposed behaviors but based on true physical ability. If a worker has not given maximum effort with items tested, this will be noted.
• The information will allow you to place a client at the safest level of work, avoiding activities beyond his/her physical abilities while permitting the highest level of function possible.

Who benefits from this information?

• Workers gain better understanding of their physical capabilities, increased confidence in their ability to work safely at the level identified, and insight to safer work practices.
• Physicians can establish an appropriate work level at the end of healing based on diagnosis and demonstrated abilities, can identify weaknesses or losses of endurance that could be improved by rehabilitation, and can assist with defining functional levels for disability hearings.
• Rehabilitation or Vocational Specialists can use the information to facilitate appropriate (and successful) transition to work and/or appropriate job placement, or can determine need for retraining.
• Employers receive clear return-to-work information for appropriate job placement.
• Attorneys receive objective information regarding a client's functional abilities to settle worker's compensation disputes and disability hearings.

Functional Job Analysis (FJA) is an evaluation process which identifies the physical demands of work. It is a structured, individualized method of work categorization that involves analysis of the worker, the work, and the worksite.

FJA can be used for some or all of the following:

• Identifying critical job demands/essential functions and writing Functional Job Descriptions assists:

• hiring practices
• worker placement (matching worker's abilities to the work)
• development of pre-work screens  
• issues involving reasonable accommodation
• development of appropriate job rotation
• identification of issues requiring ergonomic intervention
• development of programs for injury prevention education

Our occupational and physical therapy staff is fully trained by Isernhagen Work Systems to develop functional job descriptions and design accurate pre-work screens for businesses and industries.

A pre-work screen is a tool used to match a worker's abilities to the physical demands of a job. Using a functional job description, accurate pre-work screens can be designed to test whether an individual worker is able to work safely at the level required (with or without reasonable accommodation).

Although using a pre-work screen as part of the hiring process does not guarantee that a worker will never be injured, it does determine, at the time of employment, whether or not the worker demonstrates the ability to do the job safely. It identifies obvious, at risk individuals and ensures good job placement.

According to ADA, pre-employment medical exams can be performed after a conditional offer of employment has been made. The condition of employment is whether or not the worker passes the exam.

However, the screen must accurately replicate the job tasks to ensure fair hiring practices for all employees, and reasonable accommodation must be considered. If a pre-work, post-offer screen is used, it must be used consistently for all new hires to avoid discrimination.

Addition, any time changes are made to the job which either increase of decrease the physical demands, the job description and any job screens must be updated to reflect those changes.

October to December 2006

• Eleven clients entered the program. Eight clients completed the program (one client was referred to the pain management clinic, followed by a functional capacity evaluation; 1 requested discharge due to lack of insurance coverage; and one client was frequently absent and requested discharge in order to return to work).
• All clients who completed the program returned to work or were ready to return to work when discharged from therapy. Seven had jobs to return to and one was seeking employment.
• Of the seven clients returning directly to work, all seven returned to the same employer and the same job.
• The average length of stay in the program was 3.5 weeks.

January to March 2007

• Fifteen clients entered the program, and12 clients completed the program. (One client was discharged due to sporadic attendance, limiting ability to progress and meet therapy goals. Two clients developed increased discomfort and were referred to surgery for further evaluation.)
• All 12 clients who completed the program returned to work or were ready to return to work when discharged from therapy. Eleven clients had jobs to return to. One client had been self-employed for many years prior to involvement in program and was uncertain of plan for return to work at discharge.
• Of the eleven clients who returned directly to work, ten (83%) returned to the same employer and the same job. One client had a new job.
• Eleven of 12 (92%) were released to work full time hours.
• The average length of stay was 2.9 weeks.

Work Conditioning is a 1-2 week program that is designed to be a brief physical "tune-up." If during the initial evaluation, the worker demonstrates abilities consistent with critical job demands but has poor understanding of body mechanics and/or low endurance to tolerate a full work shift, he/she would be considered an appropriate candidate for a work conditioning program.

Our work conditioning program emphasizes aerobic conditioning, use of good body mechanics, and safe work practices. It can be 3-5 days per week and 3-5 hours per day, based on the worker's needs. Work conditioning is frequently combined with appropriatly modified duty.

Work hardening is a concept that was developed to bridge the gap between the acute stage of an illness and eventual return to work. Its purpose is to return the injured employee to productivity quickly and safely, and to teach the employee how to decrease the risk of another injury.

Our CARF accredited work hardening program offers a comprehensive, multi-disciplinary, and goal-oriented approach to worker rehabilitation. Work hardening clients have sometimes been off work for weeks, months, or even years. The original injury has often healed, but the worker may have lost strength, range of motion, and/or confidence in his or her ability to return to work. Often, the worker will still have pain or other symptoms with certain movements or positions. The work hardening environment is structured to gradually increase the worker's productivity while managing related symptoms.

The rehabilitation process begins with an initial assessment of the worker's current tolerance to a variety of work tasks and static postures. This one-day evaluation is completed by an occupational therapist and a physical therapist. The worker is also evaluated by a rehabilitation psychologist (to evaluate related psychological issues such as fear of re-injury and potential barriers to return to work) and a physiatrist (a medical doctor specializing in physical medicine who oversees medical management of the rehabilitation process).

Information gained is then compared to the worker's diagnosis and regular job demands and used by the multidisciplinary team to make return to work recommendations or to plan an appropriate course of treatment for successful return to work.

If deemed appropriate, the worker will enter the work hardening program. Our typical program is 5 days/week, 4-5 hours/day and can be combined with appropriate modified duty.

Initially, the program focuses on general conditioning activities as well as stretching and strengthening exercises specific to the individual's diagnosis and level of tolerance. As the program progresses, a greater amount of time is spent performing more work specific tasks. The pace and intensity of the rehabilitation program is gradually increased until the worker is performing at a functional level that is consistent with job demands or has maximized potential for improvement. Workers are also taught appropriate strategies for injury management and prevention of reoccurrence.

While in the program, weekly contacts are maintained with the worker's insurance company/rehab nurse to update them on worker's progress and plan. The employer is involved as needed to coordinate modified duty and facilitate return to work.

At the conclusion of the program, the physiatrist is able to make return to work recommendations based on the worker's demonstrated performance in the work hardening program.