Work conditioning is a topic we love to talk about because so much progress can be made here! A common thing that you see with providers of work conditioning, unfortunately, is that there is a large variety in how work conditioning is administered. Some may see their clients only two times a week for a few weeks or three, or five. It appears to be random with very little structure or it's really just 'extended' physical therapy- the same physical therapy exercises that were done in the acute phase. Just done for a longer period of time.
So let's bring some structure to the approach. The most important consideration for work conditioning is when should it happen? The answer is at the end of the acute phase of healing (see our post on acute physical therapy). The healing is still occurring but the tissue is at a stage where it can be strengthened. Using the principles of wound healing and exercise physiology, great gains in performance can be made in a safe and effective way. During this time we test to see if the client is giving a full effort. If full effort is being given we will continue until job goals are met. If full effort is not being given then we will reassess at intervals to determine the best course of treatment. We may recommend a functional capacity evaluation if attendance was an issue but often enough data is available to make a functional capacity evaluation unnecessary.
This approach results in less time spent in physical therapy, less time in work conditioning, lower cost, and defensible results.
So let's bring some structure to the approach. The most important consideration for work conditioning is when should it happen? The answer is at the end of the acute phase of healing (see our post on acute physical therapy). The healing is still occurring but the tissue is at a stage where it can be strengthened. Using the principles of wound healing and exercise physiology, great gains in performance can be made in a safe and effective way. During this time we test to see if the client is giving a full effort. If full effort is being given we will continue until job goals are met. If full effort is not being given then we will reassess at intervals to determine the best course of treatment. We may recommend a functional capacity evaluation if attendance was an issue but often enough data is available to make a functional capacity evaluation unnecessary.
This approach results in less time spent in physical therapy, less time in work conditioning, lower cost, and defensible results.