Work hardening is a systematic program of gradually progressive, work related activities performed with proper body mechanics to physically and psychologically recondition the client in order to facilitate return to full employment. Using a highly specialized rehabilitation program, work hardening is designed to span the transition from traditional rehabilitation to return to work by simulating workplace activities in a safe and monitored environment. The primary goal of work hardening is to restore functional and work capacities by applying a graded work simulation using activities designed to improve overall physical condition, including strength, endurance, and coordination tailored to specific work demands. In general, the tasks are designed to simulate work and work environments to improve the patient’s tolerance for productive work. Work hardening may be prescribed to assist a patient in achieving an acceptable level of productivity for returning to a prior occupation or to be able to meet the demands of a specific new job. In work hardening, worker behaviors are addressed in addition to physical conditioning and demands; these may include structured work times and duties, dressing appropriately for duties, and conducting oneself in a work-like manner. Worker behaviors are not addressed in work conditioning, which is primarily focused on the worker meeting physical demands with proper body mechanics and safety. Coastal Rehabilitation’s therapists will design a specific and individualized program to help you achieve the goals to meet job demands. Programs may include strengthening, stretching, body mechanics, coordination, proprioception, balance, safety, behavior modification, task modification, work pacing, and problem solving. CRI provides individualized programs in work conditioning and work hardening to help you transition from acute injury to a successful return to work. Our programs are designed to improve the biomechanical, neuromuscular, cardiovascular and psychosocial functioning of workers.  Work conditioning and hardening programs at CRI include development of tolerance for physical demands, simulation of critical work demands and tasks, education about your condition, safety and injury prevention training in a safe and monitored environment.

Functional Capacity Evaluation (FCE) is a systematic method of measuring an individual’s ability to perform meaningful tasks on a safe and dependable basis. An FCE is an intensive, short-term (typically 4 -6 hours) evaluation that focuses on assessing the individual’s major physical tolerance and abilities. Overall, an FCE is a thorough and accurate evaluation process that documents an individual’s residual physical abilities, level of effort expended during testing, reliability of reports of pain and limitation. Due to the extensive and accurate nature of this evaluation, an FCE is the single most reliable measure for determining if an individual may be able to return to work. Through the evaluation of range of motion, strength, endurance, stamina, tolerance for functional activities, posture, lifting, carrying, speed, flexibility, and skill, an FCE is an overall gauge of feasibility for employment. Generally, an FCE assesses an individual’s work tolerance and abilities, as well as possible need for work restrictions or modifications. FCE’s value to the individual is the focus on functional ability versus the pain limitation associated with impairment.

Beyond the main purpose for an FCE, it can also be utilized to fulfill alternate purposes including:

• Improve the likelihood that a patient will be safe in returning to work and performing their subsequent job task.
• Compare the patient’s abilities to a job’s demands and attempt to diminish the risk of re-injury by preventing mismatch abilities and job demands.
• Help a patient to improve role performance through identification of functional decrements and provide resolutions or compensatory strategies.
• Determine the presence of disability and the degree of disability.