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The Use of Exercise and Work Simulation to Re-Establish Maximum Work Capacity

By Michael Dechello MS, PT

Following a low back injury only 50% of the workers who have been off work for 6 months ever return to work, only 25% return to work after being off work for one year, and a negligible percent return to work having been off for two years.  The longer an injured worker is out or work, the less likely will return to their previous work capacity level.  The key to avoiding this problem is a focus on an early return to work!

An early return of the injured worker maximizes coping skills, functional capacity and normal activity levels.  The overall goal of any injured worker rehabilitation program is to shorten the time frame from onset of injury to a productive return to the work force.  The most efficient outcome is achieved when there is immediate intervention following an injury.  Then the acute phase of a musculoskeletal injury can be quickly addressed by the medical provider and an appropriate treatment regime established.

In the acute and later phases of recovery, injured workers benefit from physical therapy services.  Early physical therapy intervention will help with early motion, reducing pain and swelling, and reinforce a healthy attitude to an early return to work.  Many injured workers who receive appropriate early care return to their job without additional rehabilitation services.  Modified work arrangements can also be very productive in maintaining the injured workers attitude.  As in all injuries, the severity of the injury will determine the length of formal physical therapy.  However, after the acute phase a specific work condition program is the best way to assure a rapid return to the pre-injured level of work.

The critical demand level of work helps us develop an effective rehab approach.  Sedentary work level is easy to transition from physical therapy back to full duty.  When the physical demand level required by the worker increases, the challenge to return the worker also increases.  To bridge the gap from formal physical therapy to return to work, we create an aggressive return to work program tailored for each specific worker.  In those patients who are unable to return to work because of unresolved physical problems or who have not reached their full work capacity, the focus changes to restoration of work related function.

The American Physical Therapy Association, Occupational Health Physical Therapy* defines work conditioning as a program which addresses the physical issues of flexibility, strength, endurance, coordination, and work-related function for the global outcome of return to work.  Well organized Work Conditioning programs consist of a specific Operational Goal

ProPT has been providing Work Conditioning services for the past 3 years and currently expanding its services in their New Haven facility with dedicated space to provide services exclusively for the injured worker.  ProPT return to work program currently offers:

Expert Acute Post injury Management Comprehensive Work Conditioning Program

  • Job Site Assessment 
  • Ergonomic Evaluation    
  • Functional Capacity Evaluation
  • Patient/Client Eligibility

To be eligible for Work Conditioning, a patient must:

  • Have identified systemic neuromusculoskeletal physical and functional deficits that interfere with work;
  • Have a return to work goal;
  • Have stated or demonstrated willingness to participate.

For more information regarding a Work Conditioning Program or other work related services, please contact:
Michael DeChello MS,PT
Director of Physical Therapy
(203) 789-8873