Work Hardening

Overview

Work Hardening is a highly structured, productivity-oriented rehabilitation program designed to restore strength and confidence to workers following injury or illness. This program is the next step for workers that are not yet ready to safely return to work following acute physical therapy.

Work Hardening employs a mix of general conditioning exercises and job-simulated tasks, gradually increasing in physical demand until the anticipated job demands are met. Work Hardening is most beneficial for seriously deconditioned workers and those who exhibit a significant fear of re-injury.

With a minimal amount of equipment and training, this program can be easily be performed in a physical therapy clinic, providing the sub-acute and chronic window of care for the injured worker population.

Goals

• Build self-confidence and reduce fear by gradually introducing the physical demands and working conditions of the anticipated job.
  
• Provide controlled opportunities to experiment with a variety of tool and work style modifications prior to returning to work.
  
• Establish symptom control techniques through the use of work pacing, safe body mechanics, and by focusing on productivity, not the resolution of pain.
  
• Document increasing physical performance levels, supporting the reduction or elimination of current “medical restrictions.”
  
• Determine the physical demand range a worker may safely perform if a return to their prior job is not feasible.

Procedure

An initial “work plan” is developed at the physical demand level immediately below the level the worker perceives he/she can safely perform. Work levels are gradually increased until the anticipated job demands are met or the worker’s physical tolerance plateaus.

Duration

Work Hardening programs are scheduled 3-5 days per week for an average of 4-6 weeks. The daily work sessions may range from 1-3 hours depending on the complexity of the job and the worker’s individual response. In many cases, a return to modified duty or graduated return to work schedule is possible within the first 3-weeks.