Physical/Occupational Therapy ReferralTo make a referral please click on the service below:
Physical Therapists are experts in movement and function, and are trained to evaluate and treat changes in “normal” movement that can cause dysfunction. They look for abnormal movements that can be caused by many things, including:
- Loss of strength or range of motion
- Muscle and tissue tightness or restriction
- Neurological impairments
- Balance problems
- Poor postural alignment or body mechanics
Occupational therapists focus on assisting people who have mental, physical, developmental, or emotional disabilities. Their goal is to help clients have independent, productive, satisfying lives. This can be achieved with treatment by:
- Improving their ability to perform tasks in their daily lives and working environments
- Helping clients develop, recover, or maintain daily living and work skills
- Teaching clients to compensate for permanent loss of function
According to APTA, the operational definition of Work Conditioning is, an intensive, work-related, goal-oriented conditioning program designed specifically to restore systemic neuromusculoskeletal functions (e.g., joint integrity and mobility, muscle performance (including strength, power, and endurance), motor function (motor control and motor learning), range of motion (including muscle length), and cardiovascular/pulmonary functions (e.g., aerobic capacity/ endurance, circulation, and ventilation and respiration/gas exchange). The objective of the work conditioning program is to restore physical capacity and function to enable the patient/client to return to work. Typically these programs are:
- Highly individualized
- 2-4 hours per day3-5x per week
- Focus on strengthening, and endurance
- May include work-related activities
- Precedes Work Hardening in some cases
- Focus on ergonomics training
- Focus on safe body mechanics training
- Focus on providing education for maintaining appropriate and safe postures
- Working light duty.
- Inconsistencydemonstrated in PhysicalTherapy.
- Attemptedreturntowork and failed
- Demonstratestrength and/orendruance as primarybarriertoreturntowork.
- Are non-compliantwith HEP.
Work hardening programs are highly structured, goal-oriented, individualized treatment aimed at maximizing the individual’s ability to return to work. Work hardening programs address not only physical fitness, but psychological and specific work-related difficulties, such as fears and tolerance for the physical demands of work. These programs focus on the performance of work-related tasks, in real or simulated settings, nd the completion of the specific job demands of a position. Typically these programs are:
- Highly Individualized
- 4-8 hours per day 3-5x per week
- Focus on Work Simulation guided by Job Description using Dictionary of Occupational Titles or Employer provided job description
- Include Vocational Counseling
- Include Behavioral and psychological management and support
- Include educational sessions which include ergonomics training, safe body mechanics training, and symptom management at work.
- Pre-existing psych diagnosis or Situational psych diagnosis
- Cases beyond six months of outpatient physical therapy without MMI that have unsuccessfully transitioned back to work despite meeting physical job demands outlined in the functional capacity
- Cases with Questionable Behavioral Barriers to Return to Work
- Cases with history of re-injury or injury exacerbation at work
Functional Capacity Evaluation, FCE, is a systematic evaluation process designed to document a person’s current work ability from a physical ability and motivational perspective with consideration given to any existing medical impairment and/or pain syndromes. It’s primary purpose is to determine a worker’s ability to return to work following a job related injury, to help determine an injured worker’s medical impairment to assist with the settlement of their case, to determine a person’s functional loss following a personal injury, and other elements dealing with the decision of an injured worker’s ability to work at certain levels of stress. FCEs come in various forms including:
- Forensic FCEs (All incorporate this)
- Disability Determination
- Targeted Functional Assessment
- Job Specific Functional Capacity Evaluation
- Baseline Functional Capacity Evaluation
- Work Capacity Evaluation
Neuropsychological tests are specifically designed tasks used to measure a psychological function known to be linked to a particular brain structure or pathway. Tests are used for research into brain function and in a clinical setting for the diagnosis of deficits. They usually involve the systematic administration of clearly defined procedures in a formal environment. Neuropsychological tests are typically administered to a single person working with an examiner in a quiet office environment, free from distractions. Neuropsychological tests are a core component of the process of conducting neuropsychological assessment, along with personal, interpersonal and contextual factors.
Clinical Peer Review is the process by which health care professionals evaluate each other’s clinical performance. Clinical peer review is segmented by discipline. Moreover, Medical peer review has been used by the American Medical Association (AMA) to refer not only to the process of improving quality and safety in health care organizations, but also to process by which differentiation of medical opinion can be documented.
At NES we specialize in:
- Neuropsychological Case Review
- Physician Peer Review for Causation and Treatment Utilization for Liability and Workers Compensation Cases
- Functional Capacity Evaluations Review for Validity and Reliability