Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Amputation (Traumatic), Foot


Related Terms

  • Boyd Amputation
  • Chopart Amputation
  • Hindfoot Amputation
  • Traumatic Foot Amputation

Specialists

  • Clinical Psychologist
  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist
  • Plastic Surgeon
  • Prosthetist
  • Psychiatrist

Comorbid Conditions

Factors Influencing Duration

Advanced age and poor general health contribute to slow wound healing and delay physical recovery from trauma and surgery. Psychological adaptation to the injury, altered body function, and appearance are important for good recovery. Depression may slow recovery and rehabilitation. Neuroma, spur formation, and phantom limb sensations at the amputated end of the bone may cause pain that can interfere with physical rehabilitation. Lack of vocational rehabilitation will likely prolong disability. Concomitant injuries such as head trauma or internal injuries may contribute to a slower recovery and longer disability.

Medical Codes

ICD-9-CM:
896 - Traumatic Amputation of Foot (Complete) (Partial)
896.0 - Traumatic Amputation of Foot (Complete) (Partial), Unilateral, without Mention of Complication
896.1 - Traumatic Amputation of Foot (Complete) (Partial), Unilateral, Complicated
896.2 - Traumatic Amputation of Foot (Complete) (Partial), Bilateral, without Mention of Complication
896.3 - Traumatic Amputation of Foot (Complete) (Partial), Bilateral, Complicated

Rehabilitation

The goal of rehabilitation following a traumatic foot amputation is the return of the individual to as functional a lifestyle as possible and to use pre-injury status as the ultimate goal.

After surgical management of a traumatic foot amputation, rehabilitation may begin as soon as the individual is medically stable. Initial treatment includes edema control, shaping of the limb, wound healing, preventing contractures, and pain management (Gitler). The early phase of rehab focuses on exercise, controlling stump edema, wound care, and stump desensitization. Semi-rigid or conventional plaster cast sockets may be used to promote wound healing in individuals where the blood supply of the stump is uncompromised (Johannesson).

Rehabilitation should emphasize strengthening exercises of the upper extremities, primarily the shoulder depressors to facilitate use of assistive devices for gait; the uninvolved lower extremity; and the proximal joints of the involved lower extremity (Gitler). When indicated, rehabilitation should begin to focus on stretching and strengthening of the residual limb. Full range of motion of all joints on the involved limb is critical for early prosthetic fitting (Gitler). Once full range is achieved, strengthening of all muscle groups of the involved lower extremity is indicated.

Although up to 70% of individuals who suffer a traumatic amputation experience phantom limb pain, there is little evidence from randomized control trials to guide clinicians in effective treatment (Halbert). Common clinical treatment includes desensitization of the stump through the application of sensations such as pressure, massage, and vibration. Mirror therapy may also be useful for some individuals (Hegmann; Moseley).

An important component of rehabilitation is assessing not only the physical status of the individual but also the mental and social health outcomes. Inpatient rehabilitation may be beneficial to those requiring more support including future vocational options (Gitler).

FREQUENCY OF REHABILITATION VISITS
Surgical
SpecialistAmputation (Traumatic), Foot
Physical TherapistAt least 24 visits within 8 weeks
The table above represents a range of the usual acceptable number of visits for uncomplicated cases. It provides a framework based on the duration of tissue healing time and standard clinical practice.

Source: Medical Disability Advisor






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