WORK HARDENING AND WORK CONDITIONING EVALUATION
In this 2 hour evaluation, we obtain a thorough history, work history, psychosocial screening and baseline functional assessment on maximum lifting, pushing, pulling, carrying, upper extremity function and various body position capabilities. Our report clearly states our impressions of the client's effort, the job-related goals, and our recommended length and frequency of the Work Hardening or Work Conditioning program. We customize the length of the program based on evaluation results, availability of light or modified duty and program goals.
At the end of the 2 hours, we have a clear idea of the client's current functional capabilities, and we understand the work-related goals. In addition, the results of the psychosocial screening help us determine possible non-physical barriers that may prevent successful achievement of the goals. Examples of non-physical barriers include depression, chemical dependency, anxiety, fear, and other issues sometimes seen in individuals who have been off work for a long period of time.
WORK HARDENING PROGRAM
Work Hardening is for the client who is post-acute but needs more intensive rehabilitation to prepare him/her for return to work. Both general exercise and work simulation activities are stressed. As the program progresses, work simulation activities become the primary focus of the program. We follow the American Physical Therapy Association's and the Minnesota Department of Labor and Industry's guidelines for Work Hardening programs, which state that Work Hardening services should address both the physical and psychological rehabilitation needs of the client. Work Hardening clients participate in weekly group sessions with our licensed consulting psychologist to help deal with the many psychosocial issues that work-injured individuals face.
The results of the Work Hardening and Work Conditioning Evaluation help us determine which program is most appropriate for each individual. Clients who are appropriate for our Work Hardening services have both physical and psychosocial rehabilitation needs. It is important to mention that most clients who have been off work for a long period of time are struggling with psychosocial barriers such as fear, anxiety, and even anger. Work Hardening clients do not necessarily have psychological diagnoses or need psychological "counseling" - they may simply need more close supervision and guidance to work through pain, fear, and stress that is often a natural consequence of being out of work and dealing with the worker's compensation system.
FUNCTIONAL CAPACITY EVALUATION (FCE)
We have found that the best way to evaluate a person's endurance is to observe him or her in a work-like environment for several days. For this reason our Functional Capacity Evaluation is three days long. After a 2 hour baseline assessment, during which we determine client's maximum capabilities, the client returns for 2 consecutive days of endurance testing, 8 hours per day.
The activities tested during the two, 8-hour days can be very specific to a particular job or can answer a specific referral question. We spend a great deal of time prior to the evaluation making sure we understand the job requirements, the critical physical demands, and the question(s) we are being asked to answer. We can also perform a more generic evaluation if no particular job goal is identified or we are being asked to identify general abilities. The evaluation can be tailored to either the spine or to the upper or lower extremities. Because of the cumulative nature of most upper extremity injuries, our evaluation is particularly well-suited for these types of injuries, because we observe the client for two, full, 8-hour days.
Advantages to the Saunders Functional Capacity Evaluation include:
- We obtain true endurance capabilities versus extrapolating from a database or graph.
- Over the three-day period, clients become more confident in their own abilities.
- We have a longer period of time in which to observe and document consistency of effort.
