SPECIAL INTEREST AND SPECIALISATION PTSD / DEPRESSION / ANXIETY
Initial & Workplace Assessments
All specific functional assessments review the history of your current injury and any other relevant injuries or illnesses. In addition, they will perform a physical examination to identifying any postural imbalances, restricted range of motion and muscular weakness. Some of the specific components include:
I. Specific history of the nature of your injury and treatment provided to date
1. Background screening of other illnesses or physical injuries that may be limited progress
2. Discuss specific daily physical requirements of your normal job at full capacity
3. Screening for psychological barriers
4. Physical assessment including muscle and movement testing
5. Functional assessment focusing on specific movements and actions relevant to your job requirements
WORK RELATED ACTIVITY PROGRAM
A work related activity program (WRAP) is an outcome based exercise program that is tailored to the physical requirements of the injured workers pre-injury duties. A work related activity program is utilised when there is insufficient suitable duties available in the workplace or the worker is unable to perform any of the suitable duties. The primary goal of a WRAP is to improve the worker’s overall functional status by improving strength, endurance and flexibility via integrating a graded exercise program. The program aims to:
- Promote activity and recovery in workers with soft tissue injury.
- Encourage functional activity and independence using a cognitive behavioural and educative approach.
- Review the workplace assessment and match the prescribed work related activity to the job demands.
- Implement pacing and graded exposure to activity to plan for more movement.
- Reset the worker’s ‘pain memory’ using normal movement.
- Overcome any psychological and physical barriers encountered by the worker.
REDUCED SUPERVISION EXERCISE PROGRAM
The reduced supervision exercise program forms a crucial component in the rehabilitation process of my WorkCover patients. Patients are progressed into this program once they achieve a efficient level of self management and no longer require intense one on one supervision. The type and complexity of a patients injury will significantly influence how quickly they progress to active self management. The speed of patient transition into this program is determined by multiple factors including:
- Patient self efficacy
- Ability to perform corrective exercise
- Reached a safe functional capacity
- Patient demonstrates good self management
- Symptoms have improved or decreased
- Signs of improved strength, stability and flexibility.
The program allows for a maximum of three participants to engage in their specific exercise program for a maximum duration of 60 minutes. Patients that progress into the reduced supervision program benefit from increased motivation to further improve their condition, enhanced program compliance, continuous exercise progression and supervision. Approval for treatment within this program is generally accepted as it is a cost effective scheme for the rehabilitation of employees for insurers, providers and employers.
RETURN TO WORK & EXPECTED OUTCOMES
- Improve patients understanding of pain pathways and physiology of pain and the multiple contributing factors.
- Improve clients pain-efficacy including how to work with pain to assist with activity re-engagement.
- Improve activity confidence and upgrade functions specific to work and activities of daily living (ADL’s).
- Equip clients with the practical tools and strategies to self-manage pain and activity long term.
- Achieve return to work goals.
HOW DO I GET STARTED?
Employees that have been injured at work are required to report the injury to their supervisor or return to work coordinator as soon as possible. If the injury prevents the employee from performing their normal work duties then they may be a candidate for a workers compensation claim. Patients who have an active WorkCover claim should speak to their nominated treating doctor (NTD), specialist or rehabilitation provider to arrange a referral to see our Exercise Physiologist.
If you have been injured at work, you must:
1. notify your employer as soon as possible so the incident can be recorded in the register of injuries
2. if time of work is required, see a doctor and have the doctor complete a WorkCover certificate of capacity
3. provide the certificate of capacity (with the workers declaration completed) to your employer or their insurer and attach any bills or receipts for treatment
4. participate and cooperate with the development and implementation of an injury management plan. Your employer’s insurer will be in touch to develop this plan in consultation with you
5. comply with requests for information made by the insurer within seven days. Payments may be discontinued if you do not provide this information
6. make all reasonable efforts to return to work as soon as possible
WHY CHRIS CHERRY EXERCISE PHYSIOLOGY?
I specialise in work related injuries and motor vehicle accidents by providing active exercise therapy to enhance your recovery time and capacity to return to work. I encourage injured workers to take an active role in their rehabilitation program by providing all the education and tools necessary to achieve self management of injury and activities. Early return to work forms a crucial role in the recovery of my patients and reduces loss of function and long term disability.
I take a biopsychosocial approach and integrate evidence based cognitive behavioural principals into my programs to maximum patient outcomes. Secondary intervention usually occurs during the sub-acute phase of rehabilitation, which can range from 4 to 12 weeks after the initial injury. Secondary intervention involves continued emphasis on integration of clinical and workplace management. Incorporating functional exercise is appropriate when:
- Acute passive therapy has plateaued and functional gains are no longer occurring.
- Early treatment has been well managed and progression to a complete functional program is required.
- Pre-injury duties involve repetitive manual handling and demanding tasks.
- The worker requires a high level of supervision and education.
- Post operative rehabilitation to regain complete function.
- There are indications of psychosocial barriers limiting progress.
According to WorkCover NSW, soft tissue injuries, specifically sprains and strains, were the most common type of work related injury resulting in loss of work in 2005/06. Soft tissue injury refers to injuries of the muscles, joints, ligaments, cartilage, tendons or connective tissues (including intervertebral disc injuries). In 2005/06, WorkCover reported that manual handling was the most common cause of injury (31%) sustained by workers within workplaces.