Academy of Orthopaedic Physical Therapy

American Physical Therapy Association (APTA)

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20.3 Physical Therapy for the Performing Artist
Table of Contents

WORK INJURY PREVENTION AND MANAGEMENT: DETERMINING PHYSICAL JOB DEMANDS

Abstract:

CONTENT: The main premise of this monograph focuses on the value and applications of obtaining job-related information in injury prevention and injury management programs. The authors distinguish the difference between jobs described using standardized descriptions versus obtaining setting-specific job data. The benefits and limitations of each approach are discussed. Differences between essential and marginal job functions are then highlighted. The steps of a job analysis are reviewed including working with the employer, obtaining and analyzing the data, and writing the report. The importance of gap analysis and job matching for client evaluation, goal setting, and interventions are also described. The eclectic approach by the authors presents commonly accepted information that meets a range of stakeholder needs without representing a specific postprofessional training model. This approach allows readers to identify what works best for their individual practice setting. The information will serve as a strong foundation to explore additional opportunities for training and mentoring. CASE ANALYSES: Two case studies conclude the monograph. The first case involves a truck driver and highlights the use of job analysis in clinical care. The second case involves a nurse and demonstrates multiple uses of job analysis information.

Keywords:​

occupational health, job task, ergonomics

References:

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WORK INJURY PREVENTION AND MANAGEMENT: LEGAL AND REGULATORY CONSIDERATIONS

Abstract:

CONTENT: In the monograph, the author presents a dynamic perspective regarding the ever-changing landscape of the legal requirement in the industrial area of worker injury and prevention. This monograph provides the reader a strong understanding of how to not only enter into this area of practice but also how to avoid being unaware of the guidelines one needs to consider to be successful and legally accountable. An overview of the laws and regulations that directly apply to injury and prevention are discussed. These include state worker's compensation laws, the Americans with Disabilities Act, and also the Family and Medical Leave Act. Employment screens under the ADA are also covered. Specific content addresses how the ADA impacts the scope of what can be legally tested and reported to an employer in an employer-requested functional capacity evaluation. Case law examples are also included to provide application and clarity in interpretation. An informative section on the distinction between Agility Screening and Post-offer Screening is also particularly relevant to clinicians. Information in the physical therapist's record that will assist a worker's compensation tribunal in a worker's compensation controversy is also presented. An entire section is dedicated to how HIPAA applies uniquely to worker's compensation cases as well as exceptions to a written authorization release. CASE ANALYSES: Embedded case law examples are included.

Keywords:​

law, occupational health, HIPAA

References:

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WORK INJURY PREVENTION AND MANAGEMENT: THE ROLE OF THE PHYSICAL THERAPY IN INJURY REDUCTION/PREVENTION AND WORKFORCE WELLNESS

Abstract:

CONTENT: The monograph outlines the varied roles of the therapist in industry. The author first compares and contrasts each of the three tiers of prevention. Key stakeholders in work injury prevention are described. Workplace injury reporting and management measures are defined according to financial, quality of life, and chronic conditions. Common cost drivers associated with workplace wellness and key areas of direct and indirect costs associated with worker health and safety are identified. The reader will gain an appreciation of the complexities associated with work-injury management and common approaches will be discussed. Models and components of a successful workplace wellness program are presented along with outcomes. CASE ANALYSES: A review of some different model applications of prevention in the workplace. These include an On-Site Musculoskeletal Emphasis, “On-site” clinics that offer only occupational health services, embedded professional and also biometrics providers.

Keywords:​

ergonomics, safety, industry

References:

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WORK INJURY PREVENTION AND MANAGEMENT: INJURY MANAGEMENT CONSIDERING EMPLOYMENT GOALS

Abstract:

CONTENT: Opportunities exist for physical therapists in the workplace. To become a consultant in work injury and injury prevention management requires knowledge of the industry. This monograph introduces employment goals from the perspective of the employer and also the employee with regard to work injury prevention and management. The path of the injured worker from incident through the workers' compensation system is detailed using Hadler's scheme. Employer responsibilities in reference to the Americans with Disabilities Act and Americans with Disabilities Amendments Act are then discussed. Unique opportunities for the physical therapist are highlighted. The areas of functional job analysis, ergonomics, pre-employment testing, and education are highlighted. In addition, condition-specific and work-specific outcomes measures are applied to various return-to-work and work-injury scenarios. CASE ANALYSES: Two case studies are part of the monograph. The first case describes a 47-year-old male employee with knee pain attributed to climbing down from a forklift. The second case is a 52-year-old mechanic who presents with gradual lateral elbow pain related to his occupational use of hand tools.

Keywords:​

occupational health, wellness, physical therapy

References:

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WORK INJURY PREVENTION AND MANAGEMENT: ERGONOMICS

Abstract:

CONTENT: The rising costs of health care have created a clinical niche in industry ergonomics. This monograph defines the roles of the physical therapist as a consultant to the workplace for preventing work-related musculoskeletal disorders. Regulatory enforcement and terminology are discussed. A detailed section on the pathophysiology of musculoskeletal disorders follows. The author then describes ergonomics and non-ergonomics risk factors for musculoskeletal disorders in the workplace according to body region. Common ergonomics assessment and evaluation tools are then described. A specific description of the workplace OSHA 300 injury record is given and its implications discussed. Ergonomic interventions and tactics are highlighted based on work environments. Furthermore, barriers to successful outcomes are explained and the use of financial resources are described. CASE ANALYSES: Two case reports are presented. The first case report describes a step-by-step ergonomic process from assessment to intervention. A second case report provides a similar analysis for multiple workplaces. The monograph concludes with a section listing recommended resources and tools.

Keywords:​

wellness, safety, physical therapy

References:

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WORK INJURY PREVENTION, MANAGEMENT COORDINATION, AND COMMUNICATION

Abstract:

CONTENT: The monograph covers key components of a successful work injury prevention program. The roles and responsibilities of not only the physical therapist but also other members of the injury prevention and management team are elucidated. Specific sections address the impact of ergonomics, the role of the safety manager, human resource consultants, team leads, and supervisors. There is also a discussion on the role of employee representation and its critical importance in quality improvement and compliance. The designated medical provider and the case manager are also highlighted as to their role in injury prevention. The difference between a common description of a job's physical demands and a job-specific task are clarified. Job description examples are provided and the value of multidisciplinary meetings is described. The author promotes the use of first aid training and early injury reporting to decrease injury rates. The key elements of a post-offer pre-employment testing are outlined and the authors show how pre-employment post-offer testing can benefit employers. A section on disability management, advocates proper treatment for the employee once an injury occurs. A section on common ergonomic tools and processes for measuring job risk follows with a concluding section on identification of key components of communication in an injury prevention program. CASE ANALYSES: Two case studies support the monograph. The first describes a 56-year-old female stocking clerk who has a history of carpal tunnel surgery. The second case is a 34-year-old male who has been offered a job as a warehouse worker contingent upon passing the post-offer test and whose past medical history includes a spinal fusion 3 years ago.

Keywords:​

ergonomics, safety, physical therapy

References:

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