Work Hardening: Past, Present, and Future — The Work Programs Special Interest Section National Work-Hardening Outcome Study

Abstract

The authors suggest a need for uniform standards in collection of outcome data to establish a basis for comparison of efficacy among programs. Recommendations include tracking comparison or control groups, grouping clients in terms of length of disability, computing success rate on the basis of number of clients who completed their program, using relevant subcategories when reporting return to work, and consistency of the postdischarge interval for follow-up.

A work‐oriented occupational therapy programme for individuals with physical disabilities

“…Without effective support services from a comprehensive vocational rehabilitation programme that includes a liberal worker compensation system and social benefits policy, healthy attitudes towards disabilities, equal employment opportunities, and barrier-free physical environment, the WOOTP would not be effective. Reported successful return to work rates for work-related programmes have ranged from 40 to 80% (Howard et al, 1985;Caruso, Chan & Chan, 1987;Lyons & Morse, 1988;Black-Schaffer & Osberg, 1990;Krause, 1992;Ogden-Niemeyer et al, 1994). Compared with similar studies, the return-to-work rate of WOOTP seems lower than average.…”

The Work Hardening Program and Subsequent Return to Work of a Client With Low Back Pain

“…The outcome data that have been reported reveal success rates ranging from 39 to 88% (16,19,26,35 ing treatment approaches, method-75% return to work rate in a 4week, ologies, and research designs have 3% days/week program (37). Hazard been utilized (24,26).…”

“…While most acute low back injuries resolve within 6 weeks (19,35), a small percentage of patients continue to report symptoms after 3 months (19,32,35). Review of the literature reflects the notion that prolonged rest and conventional physical therapy are not effective in the treatment of the chronic sufferer (25,27,32).…”

“…If, in fact, more than 3 months of absence from work occurs, the rate of return to work drops significantly (19,35). This small percentage of people ( 5 1 5 % ) who develop chronic pain account for 85% of the workers' compensation costs (16,29,31,34,39,40,43).…”

“…Interdisciplinary perspectives, combined with the recognition of psyche social factors, led the way to the development of work hardening p r e grams in the late 1970s (3,4,12,16,19,20,21,(25)(26)(27)(28)(29)(30). By 1988, 500 such programs existed in the United States and were offering their services (35).…”