Work - Volume 4, issue 1

Authors: Jacobs, Karen

Article Type: Other

DOI: 10.3233/WOR-1994-4101

Citation: Work, vol. 4, no. 1, pp. 1-1, 1994

Authors: Niemeyer, Linda O. | Foto, Mary | Holmes-Enix, Debbie

Article Type: Research Article

Abstract: Managed care, with all its problems and potentials, is entering the scene in workers' compensation as a way to deal with escalating costs. Though the roots of managed care lie in cost containment efforts, its future depends on a shift in emphasis to quality of care. Clinicians must become partners with insurance companies and employers to evolve a “win-win” scenario that combines efficiency with effectiveness or risk both exclusion from provider networks and loss of control over what becomes incorporated into standards of care. Steps that can be taken by clinicians include developing a sense of accountability for final functional …outcome, internal utilization management, and an internal case management protocol. Show more

Keywords: Managed care, Case management, Utilization management, Industrial rehabilitation

DOI: 10.3233/WOR-1994-4102

Citation: Work, vol. 4, no. 1, pp. 2-8, 1994

Authors: Graly, Jane M. | Yi, Sang | Jensen, Gail M. | Gibson, Marianne | Laborde, Tom

Article Type: Research Article

Abstract: This pilot study investigated whether a simple statistical analysis of selected intake data in the charts of work-hardening clients could differentiate those clients who returned to work from those who did not. Data from 24 workers' compensation clients were examined. Perceived pain on initial evaluation was the only statistically significant variable (p<0.01). Lower pain levels correlated with a successful return to work. Statistical trends (p<0.10) suggested that a lower hourly wage, a higher occupational metabolic equivalent level, and a marital status of married or cohabitating correlated with a successful return to work. Data were used to describe a client at …risk – one with high levels of pain, who was not in a physically demanding Job and lacked social support. Program recommendations were made to address these issues. It was concluded that as other work-hardening centers respond to the call for better outcome assessment, a similar design process could be used. Show more

Keywords: Work-hardening, Return to work, Workers' compensation, Outcome assessment

DOI: 10.3233/WOR-1994-4103

Citation: Work, vol. 4, no. 1, pp. 9-21, 1994

Authors: Thompson, Lori | Pati, A.B. | Davidson, Harriet | Hirsh, David

Article Type: Research Article

Abstract: This study, conducted on hospital workers, investigated the influence of wearing back belts on employee job attitudes and the experience of back pain. Serial attitude surveys were administered to workers involved in a preventative program of education, exercise, and back belts. Attitudes were found to be significantly improved as a result of the back belt program. Employees perceived back belts as helping them avoid injury and reported a decreased experience of low back pain.

Keywords: Attitudes, Back belt, Back pain, Prevention, Supports

DOI: 10.3233/WOR-1994-4104

Citation: Work, vol. 4, no. 1, pp. 22-27, 1994

Authors: Ambrosius, Frank M. | Rounds, Barbara K. | Herkner, Peter B. | Dekraker, Mark A. | Bartz, Steven R.

Article Type: Research Article

Abstract: This study examined 94 injured workers (IWs) treated in a work-hardening program over an 18-month time span. Of the 94 subjects, 78 (82.98 %) were contacted by telephone 1 year after discharge from therapy. Data examined include demographic, therapeutic, and return-to-employment information. Discriminant analyses showed that 74 of the 94 IWs were not working while involved in work hardening. Of these, 70 IWs (94.59 %) were released to gainful employment on discharge. At the time of the follow-up call, 53 of the IWs (67.95 %) were still working. Of the 25 IWs not working, 18 (69.23 %) were involved in …litigation. The average subjective pain level for the nonworking group, on a 0–10 scale, was found to be twice that of the working group, 5.35 vs. 2.48 (p<.01). It was also discovered that 100 % of the IWs not working at follow up who were previously deemed noncompliant with work hardening were involved in a disputed claim. This study also found that noncompliant individuals were discharged from therapy much earlier than compliant subjects, after 5.5 versus 14.4 visits, and at a much lower cost, $798.39 versus $2,137.01. These results suggest that although “state-of-the-art” programming was administered, behavioral and psychosocial factors (compliance and litigation) confounded the reactivation outcome process. Implications for future research directions are discussed. Show more

Keywords: Return to work, Follow up, Behavioral/Psychosocial factors

DOI: 10.3233/WOR-1994-4105

Citation: Work, vol. 4, no. 1, pp. 28-34, 1994

Authors: Roberts, Gary | Zimbrich, Karen

Article Type: Research Article

Abstract: Job accommodation is an essential ingredient of employment for individuals with physical disabilities. Services such as supported employment have improved employment opportunities. However, rehabilitation practitioners encounter an increasingly varied and complex array of accommodation options from which to choose. This article describes the Job Accommodation System, a user-friendly tool that assists rehabilitation practitioners, employees, and employers to identify and implement job accommodations.

Keywords: ADA, Americans with Disabilities Act, Assistive technology, Cognitive disability, Employment training specialist, Functional capacity, Job accommodation, Job analysis, Physical disability, Special education, Supported employment, Vocational rehabilitation

DOI: 10.3233/WOR-1994-4106

Citation: Work, vol. 4, no. 1, pp. 35-45, 1994

Authors: O'Connell, Dennis G. | Holmes, Clayton F. | Santos, Jose L. | Jordan, Eddie | Acosta, Francisco

Article Type: Research Article

Abstract: The purpose of this investigation was to examine the metabolic and cardiopulmonary responses of an experienced therapist (8 years experience) performing manual therapy at standard (S) plinth height (31 in), elevated (E) plinth height (38 in), and standard (SMTH) and elevated (EMTH) plinth height wearing a manual therapy harness (MTH). The MTH, developed by one of the investigators (J.L.S.), is a vestlike device worn by the therapist, which, when attached to the patient, can be used to distract articular surfaces. The MTH allows the therapist more freedom of hand movement and use of body weight to help provide joint distraction. …Inferior glide (Grade 3-Maitland) was provided to the lift hip of 12 individuals at a rate of 20 oscillations per minute for 4 minutes, continuously, so that steady-rate metabolic conditions could be established. Mean body mass and height for the 12 individuals was 70±10.5 kg and 174.5±13 cm, respectively. The therapist's heart rate returned to resting levels between each of the randomly assigned treatments. One subject was treated daily. The therapist (age 32) was chosen because of his clinical experience, similar height (172 em) and weight (73 kg) to the average adult American male, and excellent intra- and interday (5%≤ METs, 5%≤ HR) reproducibility. Metabolic equivalents (METs), heart rate (HR), and rate of perceived exertion (RPE) were measured and averaged for the last 2 minutes of each treatment condition. The therapist was unaware of day-to-day test results except for RPE. Mean METs were 3. 7,3.2,2.6, and 2.4 for S, E, SMTH, and EMTH, respectively. Mean HRs were .117, 110, 104, and 93 beats/min for S, E, SMTH, and EMTH, respectively. RPE was 11. 0,8.7, 7.9, and 7.3jorS, E, SMTH, and EMTH, respectively. Repeated-measures analysis of variance (Scheffé F-test) revealed that SMTH and EMTH METs were similar, and significantly different (p≤0.05) from Sand E. METs for E were significantly different and lower than for S. HRs were significantly greater during E than the SMTH condition. RPE for S was significantly greater than SMTH, E, or EMTH. It can be concluded that the MTH significantly reduced the physiologic cost of providing manual therapy at either standard or elevated plinth height. further studies on these types of assistive devices and the effects of health status of the therapist on the provision of manual therapy treatments at various plinth heights are needed. Show more

Keywords: Energy cost, Oxygen consumption, Ergonomics, Manual therapy, Assistive devices

DOI: 10.3233/WOR-1994-4107

Citation: Work, vol. 4, no. 1, pp. 46-55, 1994

Authors: Carifio, James | Lanza, Marilyn

Article Type: Research Article

Abstract: This study compared all possible orders of responding to three vignettes describing incidents between a male patient and a female nurse in which the nurse is mildly assaulted, severely assaulted, or verbally abused by the patient (the control condition). Subjects were 32 female senior-year nursing students and 28 practicing nurses. It was found that response levels to a given vignette could predict a respondent's response to the other vignettes. Also, a significant “bench-marking” effect was found: if a subject responded to the mild assault vignette first, the subject's overall response pattern best fit the general nonlinear assignment-of-blame pattern observed, but …if the subject responded to the severe assault or control vignette first, this vignette set a bench mark for responding from which the subject's subsequent responses did not deviate greatly, which slightly distorted the subject's V-shaped nonlinear response pattern. Show more

Keywords: Assault, Violence, Simulations, Nonlinear relationships, Predictive validity

DOI: 10.3233/WOR-1994-4108

Citation: Work, vol. 4, no. 1, pp. 56-67, 1994

Authors: Cass Baldwin, Cheryl

Article Type: Research Article

Abstract: Good communication can be the most effective therapeutic and marketing tool used within an industrial rehabilitation program. Effective communication among professionals is a key way to establish and maintain an atmosphere of professional cohesiveness (Osborne and Courts, 1991). The benefits of good communication are numerous. Strong treatment planning, smooth transitions back to work, identifying symptom magnifiers, eliminating team splitting, and having new learning opportunities for professionals are among the benefits found most often in industrial rehabilitation (Brown, 1991).

Keywords: Communication, Treatment planning, Industrial rehabilitation, Team building

DOI: 10.3233/WOR-1994-4109

Citation: Work, vol. 4, no. 1, pp. 68-70, 1994

Authors: Rice, Valerie J.

Article Type: Other

Abstract: This article is an information update on issues in ergonomics. Ergonomic certification is currently being conducted by the Board of Certification in Professional Ergonomics. Ergonomic certification is also being discussed by health care professionals and has been addressed by the National Interdisciplinary Committee on Health Ergonomics. The activities of each organization are presented.

Keywords: Ergonomics, Certification, Health care

DOI: 10.3233/WOR-1994-4110

Citation: Work, vol. 4, no. 1, pp. 71-72, 1994