SpineCenterAtlanta is proud to offer a comprehensive Work Conditioning Program, available to patients with appropriate physician orders and with proper authorization through the patient’s worker’s compensation representative, either the Adjuster and/or Nurse Case Manager.
Definition: According to the United State Department of Labor and Industries, Work Conditioning is “an interdisciplinary, individualized, job specific program of activity with the goal of returning to work. Work Conditioning programs use real or simulated work tasks and progressively graded conditioning exercises that are based on the individual’s tolerances. Work Conditioning Programs provide a transition between the acute care and successful return to work and is designed to improve the biomechanical, neuromuscular, cardiovascular, and psychosocial functioning of the worker”.
Qualifications:
- The worker must have a valid order for Work Conditioning from a licensed practitioner of the healing arts.
- The worker must be covered under Worker’s Compensation insurance and have the appropriate approval from the Adjuster and/or Nurse Case Manager to engage in such a program.
- The worker must have engaged in and successfully completed a routine of physical therapy which has adequately prepared the worker to engage in a Work Conditioning Program.
- The worker must be of adequate health such that the worker can engage in and tolerate a program of conditioning and work simulation between 2 and 4 hours, 3 to 5 days per week. The worker must have stable vital signs prior to entering the program AND at each visit.
- At any given time during the Work Conditioning program, the patient’s resting heart rate may not exceed 75 beats per minute, the patient’s target heart rate may not exceed 80% of that patient’s calculated maximum heart rate (220 minus the patient’s age), AND the patient’s diastolic blood pressure may not exceed a reading of “95″.
- The worker must agree the engage in the Work Conditioning Program and have as one of their goals the return to gainful employment, even if a return to the previous/original job is not a realistic expectation of the patient and/or physician.
Patient Preparations:
- The patient is to wear loose and comfortable clothing to each Work Conditioning session. And the patient’s attire should closely resemble the type of attire worn at work, although wearing one’s “uniform” to each session is not necessary. Comfortable and safe shoes should be worn since conditioning/aerobic activities are utilized in this program.
- The patient should eat a healthy breakfast (if engaging in an AM Work Conditioning session) or a healthy lunch (if engaging in a PM Work Conditioning session). This will avoid blood sugar level fluctuations during the program. The patient should hydrate adequately and also plan to drink water or replacement fluids during the Work Conditioning session.
- Please do not bring friends, family or visitors to a Work Conditioning session. The Work Conditioning sessions are of greater length than a regular physical therapy session. Space constraints in the clinic and in the Reception Area make it difficult for the facility to accommodate visitors for several hours.
- It is important to be timely to Work Conditioning sessions. All 4-hour sessions begin promptly at 8:15am OR 1:00pm.
- The patient is to assist the therapy staff in securing a current/valid Job Description from the employer, Adjuster and/or Nurse Case Manager. If there is no Job Description, it is important to notify the staff of such. Workers engaged in a Work Conditioning Program without a Job Description will be conditioned for a generic job category such as “laborer”, “construction”, “secretarial”, “retail”, etc., whichever category best fits the worker’s job type.
Program Parameters:
- The worker is scheduled for an initial evaluation session with the lead Work Conditioning therapist UNLESS the patient has already engaged in a physical therapy routine at this location/facility. In this case, the worker has already been evaluated, with a comprehensive history taken and a plan of care and goals in place.
- The Work Conditioning Program lasts 12 to 25 visits total, depending upon physician orders and worker’s compensation approval. Programs are either 3 days/week or 5 day/week and last from 4 to 5 weeks.
- Work Conditioning Program sessions vary in length but generally begin at 1½ to 2 hours and continue up to a maximum of 4 hours. The worker is progressed through the program, increasing duration, intensity, frequency, and type of activity (DIFT) each time the worker attends a session.
- The Work Conditioning Program does NOT include typical physical therapy modalities such as heat, ice, massage, ultrasound, electrical stimulation, aquatics, etc. Those modalities and/or treatments are reserved for patients engaged in acute or sub-acute physical therapy programs. The Work Conditioning client is expected to tolerate conditioning and work simulated activities without the use of pain-controlling or pain-relieving therapies. Exceptions do apply and these dependent upon physician orders and the worker’s feedback as the program progresses.
- For those workers who find it necessary, this facility has, with approval of the insurance company, the ability to refer patient’s for vocational and/or psychological counseling services.
- The worker can expect mild to moderate soreness during the early stages of the Work Conditioning Program, which should improve dramatically during the program’s progression.
- A 24-hour notice is required for all appointment changes. Missed appointments are logged in the worker’s chart and the Adjuster and/or Nurse Case Manager is notified of all missed appointments. The Work Conditioning Program is NOT successful if attendance is sporadic.
Program Conclusion:
- Once the Work Conditioning Program is concluded, the worker can expect one of the following to occur: The worker will be returned to work with or without restrictions based upon physician input and employer cooperation.
- The worker will be sent for an FCE (Functional Capacity Evaluation), and assessment conducted by a physical therapist which consists of a battery of physical “tests” to determine what the worker may/may not tolerate upon return to work, including classifying the worker’s return-to-work category as “sedentary”, “light”, “medium”, “heavy”, or “very heavy”.
- The worker will receive an Impairment Rating from the ATP (Authorized Treating Physician).
- No further physical therapy is indicated once the Work Conditioning Program is concluded, as the worker should have achieved Maximum Medical Improvement at the conclusion of the Work Conditioning Program. Moving forward, the worker must typically be out of therapy for at least 60-90 days before any further therapy is indicated OR the worker must experience an exacerbation of symptoms that would indicate the need for further therapy, requiring additional orders from the ATP and with worker’s compensation agreement/approval.