Beyond physiotherapy and massage: Intensive rehab for injured workers

Issue: BCMJ, vol. 54, No. 9, November 2012, Page 454 WorkSafeBC
By: David Florkowski, PhD, MEd, ATC, CSCS, CEAS, CFCE, Robert Kobayashi, MD, BSc, CCFP, FCFP,

In last month’s WorkSafeBC article, we outlined various therapy programs available to injured workers, including physiotherapy and massage. However, sometimes these forms of therapy aren’t enough. If a worker requires additional therapy, the GP, specialist, physiotherapist, WorkSafeBC medical advisor, nurse advisor, or case manager might recommend that he or she attend a more structured and intensive rehabilitation program.

WorkSafeBC-approved private clinics offer these rehabilitative programs throughout the province. The worker is evaluated at an intake as­sessment, and, if appropriate, he or she will attend treatment for 4 to 6 hours per day, 5 days per week, for up to 10 weeks.

What does occupational rehab entail?
WorkSafeBC’s occupational rehabilitation programs are designed to gradually improve patient mobility through regular, frequent therapy sessions and ongoing consultation with the worker’s medical team. These structured physiotherapy programs provide general conditioning and simulated work tasks to prepare the worker to go back to full-time work.

Occupational rehab (OR) programs offered by WorkSafeBC 
OR1. A structured rehabilitation program run by a physiotherapist, meant to prepare the worker to return to work through physical and functional conditioning, education, and ongoing sup­port during the transition back to work. This program is offered at rehabilitation clinics and worksites. Workers should meet the following criteria:

•    Their injuries are either a soft-tissue injury or a healed surgery or fracture, and the injury should have occurred at least 3 weeks prior to the referral.
•    They have no medical contraindications to an activity-based program.
•    They are expected to benefit from exercise to improve strength, en­durance, and mobility.
This program is not recommended for the following workers:
•    Those who are currently engaged in another treatment intervention for the same injury.
•    Those who have a WorkSafeBC-accepted diagnosis of activity-related soft tissue disorder or complex regional pain syndrome.

OR2. A multidisciplinary treatment program that involves a medical team of occupational therapists, physical therapists, psychologists, and physicians. This team—with input from a WorkSafeBC officer—determines the treatment an injured worker requires to overcome barriers associated with returning to work. The program is designed for workers who meet these criteria:

•    They have an injury-related functional deficit or impairment. 
•    They have a vocational, psychosocial, or medical barrier that prevents them from returning to work.
•    They have taken part in other medical treatments, but have been unsuccessful in either returning to work or staying at work.

Hand therapy. A rehabilitative program for injured workers with acute traumatic injuries of the upper extremity, below the level of the shoulder. This includes injuries to the hands and wrists, such as open wounds, crushed fingers, tendon repairs, and burns. Pa­tients receive treatment from certified hand physiotherapists, who have specialized skills in assessing and treating lower-arm, work-related medical conditions. The program helps injured workers regain maximum function of their injured hands, wrists, or upper extremities in preparation for a safe and timely return to work. The treatment program may continue for as long as 12 weeks. The hand therapy program is designed for injured workers who meet the following criteria:

•    They have sustained an acute traumatic injury in the upper extremity, below the shoulder, and require specialized hand therapy intervention.
•    They are currently attending another WorkSafeBC-sponsored rehab­ilitation program for the same injury.

Questions?
For further information regarding WorkSafeBC’s occupational rehabilitation programs, please contact a medical advisor in the nearest WorkSafeBC office.
—David Florkowski, PhD, MEd, ATC, CSCS, CEAS, CFCE
WorkSafeBC Program Manager, Health Care Services, Visiting Specialists Clinic
—Robert Kobayashi, MD, BSc, CCFP, FCFP
WorkSafeBC Medical Advisor, Nelson Office

This article is the opinion of WorkSafeBC and has not been peer reviewed by the BCMJ Editorial Board.

David Florkowski, PhD, MEd, ATC, CSCS, CEAS, CFCE,, Robert Kobayashi, MD, BSc, CCFP, FCFP,. Beyond physiotherapy and massage: Intensive rehab for injured workers. BCMJ, Vol. 54, No. 9, November, 2012, Page(s) 454 - WorkSafeBC.


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