Industrial Rehabilitation Lecture PDF

INDUSTRIAL REHABILITATION By: Prof. Daisy M. Lopez,MPH,MSpED,PTRP,LPT 2 Rehabilitation ▹ essential part of universal health coverage along with promotion of good health, prevention of disease, treatment and palliative care. ▹ helps a child, adult or older per...

INDUSTRIAL REHABILITATION By: Prof. Daisy M. Lopez,MPH,MSpED,PTRP,LPT 2 Rehabilitation ▹ essential part of universal health coverage along with promotion of good health, prevention of disease, treatment and palliative care. ▹ helps a child, adult or older person to be as independent as possible in everyday activities and enables participation in education, work, recreation and meaningful life roles such as taking care of family. 3 ▹ Globally, an estimated 2.4 billion people are currently living with a health condition that benefits from rehabilitation. ▹ Currently, the need for rehabilitation is largely unmet. ▹ In some low- and middle-income countries, more than 50% of people do not receive the rehabilitation services they require. ▹ The existing rehabilitation services in 60-70% of countries have been disrupted due to the COVID-19 pandemic. 4 ▹ Rehabilitation is highly person-centered ▹ Rehabilitation can be provided in many different settings, from inpatient or outpatient hospital settings, to private clinics, or community settings such as an individual’s home. ▹ WORKPLACE 5 Industrial rehabilitation ▹ The WORK OF GETTING BACK TO WORK ▹ treatment and prevention of work-related injuries.... ▹ This is done by providing hands- on, evidence-based treatment to patients. 6 ▹ Communication among the physician, employer, patient and payer is facilitated by the therapist. When everyone is on the same page, return to work is optimized. ▹ We work with employers, case managers and insurers to provide comprehensive work health services 7 Industrial Rehabilitation ▹ Simply, helps an employee complete his or her job safely after an injury or illness through: ▸ Assessments ▸ Therapy ▸ Workplace adjustments 8 Focus of Industrial Rehabilitation Three main components ▹ Injury Prevention ▹ Physical Rehabilitation and Treatment ▹ Return-To-Work 9 I. INJURY PREVENTION ▹ Pre-Employment Assessment ▸ focus on determining whether an individual is physically capable of performing a specific job to proactively minimize the risk of injury. 10 What are the employer's needs when hiring? ▹ To comply with all federal legislation ▹ To hire healthy and productive workers ▹ To ensure workers are placed in jobs they are capable of performing ▹ To prevent and reduce injuries and associated costs  Prevention Programs 11 ▹ Employee education and management to recognize musculoskeletal risks ▹ Identifying ways to eliminate risk ▹ Increasing awareness through education to minimize accumulated physical stress of the job ▹ Providing customized stretching/warm-up programs to target the muscles employees use most throughout the day  Ergonomic Training 12 ▹ Ergonomics is the relationship between people and the work environment. ▹ Ergonomic Training focuses on evaluating a specific work environment and job tasks to identify risk factors that could result in musculoskeletal dysfunction.  A. Individual Ergonomic Analysis 13 ▹ Evaluate the ergonomics of an injured employee and develop strategies to adjust their workstation to decrease strain and improve efficiency.  B. Ergonomic Analysis 14 ▹ Evaluate multiple employees performing a job that has high injury rates and develop the potential solution(s) to decrease ergonomic risk factors.  C. Office Ergonomic Analysis 15 ▹ Evaluate the employee at their computer workstation, identify ergonomic risk factors and assist in developing solutions. 16 Industrial Rehab ▹ Expertise of: ▸ Physical Therapist ▸ Occupational therapist  II. Physical Rehabilitation and Treatment 17 ▹ provides complete rehabilitation management for patients who are injured or experience acute or chronic pain while at their place of employment. ▹ offered to hasten the patients return to normal functional activities, including the return to work. ▹ works directly with patients, employers, physicians, other health care providers, and attorneys to provide the best possible patient outcomes ▹ allow the patient to successfully return to the workplace. 18 III. Return to Work ▹ designed to provide job-related and injury-specific therapeutic interventions ▹ to create customized and cost- effective approaches to the treatment of work-related injuries.  Program features include: 19 ▹ Early intervention strategies and ease of access ▹ Customized clinical strategies that are aggressive, functionally-oriented and scientifically-based to facilitate early return to work ▹ Partnership approach for injured workers, healthcare team members, and employers ▹ Job simulation models for clinical advancement and early return to work ▹ Ongoing utilization/patient management  Return to Work/Work Conditioning 20 ▹ When injured workers meet established short- and long-term goals via physical therapy or occupational therapy but are unable to return to work due to remaining functional deficits or deconditioning, they may benefit from a higher level of the therapeutic intervention designed specifically with a primary goal of returning to work. 21 ▹ These are full body intensive conditioning programs that focus on work simulation activities to get injured workers back to work.  Return to Work 22 ▹ A highly structured, goal-oriented, individualized intervention program designed to return the employee to work. ▹ multidisciplinary in nature and utilize real or simulated work activities designed to restore physical, behavioral and vocational functions. ▹ addresses the issues of productivity, safety, physical tolerances and worker behaviors.  Work Conditioning 23 ▹ An intensive, goal-oriented conditioning program designed to restore neuromuscular and musculoskeletal function including strength, power, endurance, joint mobility, ROM, motor control, cardiovascular endurance and functional abilities. ▹ The primary objective of the Work Conditioning program is to restore physical capacity and function to enable the injured worker to return to his or her pre-injury job.  Functional Capacity Evaluation (FCE) 24 ▹ provides a comprehensive evaluation that measures strength, endurance, physical demand work level and positional tolerance. ▹ The data gathered through this evaluation objectively defines the injured employee's physical capabilities.  Functional Capacity Evaluation (FCE) 25 ▹ an important tool used to assist employers, physicians, insurance companies, attorneys, case managers and vocational consultants to determine safe, functional levels for an individual to either return to work or to establish functional ability. ▹ The evaluation assists referral sources by offering information for adjudication of claims in short/long- term disability, provides return-to-work capabilities and determines ability levels for liability cases using appropriate medical standards. 26 It helps you as a Worker by: ▹ Determining what tasks you were able to complete ▹ Offering a work conditioning and hardening program ▹ Providing ergonomic evaluations of your work environment ▹ After an injury you may need to figure out what work tasks you’re able to do. You might need this either to return to work or to find a new job.  FCE looks at your medical history and mimics 27 common work activities, such as: ▹ Crawling through small spaces ▹ Climbing ladders ▹ Lifting a certain amount of weight Some employees may also benefit from an ergonomic assessment. This looks at your workstation, equipment, and the tools you use each day. 28 You may get feedback for: ▹ Assistive devices ▹ Certain types of desk chairs ▹ Other workstation changes that improve posture and safety  Assessments and Services for Employers 29 ▹ Industrial rehab therapists do pre-employment physical skills tests to make sure your candidates can meet the job requirements. 30 These specialists also assess employees coming back to work after an injury or illness and: ▹ Decide if the worker can perform job functions. ▹ Offer guidance on changes that will allow the employee to return to work safely. ▹ Provide job-site shadowing and coaching. 31 ▹ Industrial rehab also offers work safety training programs for businesses. ▹ Therapists can provide group or one-on-one training in safely handling materials or proper posture and techniques to perform work- related tasks. 32 It helps you if you’re an Employer by: ▹ Determining whether an employee can perform job functions ▹ Evaluating an employee who is returning to work after an injury or illness ▹ Offering pre-employment functional capacity evaluations ▹ Providing job site shadowing and coaching ▹ Recommending modifications ▹ Teaching work safely Employer/Employee Requirements General Duty Clause ▹ Each Employer: 1. Shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees; 2. Shall comply with occupational safety and health standards promulgated under this Act. ▹ Each Employee: 1. Shall comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to this Act which are applicable to his own actions and conduct. Employee/Employer Requirements Report signs or symptoms if: ▹ Pain is persistent, severe or worsening ▹ Pain radiates ▹ Symptoms include numbness or tingling ▹ Symptoms keep you from sleeping at night ▹ Fingers blanch or turning white Employee/Employer Requirements Getting involved: ▹ Look at jobs ▹ Come up with solutions ▹ Work with solutions ▹ Take part in training ▹ Take responsibility for changing the way you do your job ▹ Help to make sure efforts are successful 36 37 References: ▹ Rehabilitation by WHO ▹ UPMC Health Beat ▹ Central Nebraska Rehabilitation Services