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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.

Fracture, Talus


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Rehabilitation

The goals of rehabilitation following a fracture of the talus are to decrease pain and to return the individual to full function with a painless mobile ankle. The duration of treatment is related to associated soft tissue involvement and type of fracture.

The main focus of rehabilitation should emphasize restoring full range of motion, strength, proprioception, and endurance while maintaining independence in all activities of daily living. While the resumption of pre-injury status is the goal, the type and location of the fracture on the talus will affect the speed and success of rehabilitation. Protocols for rehabilitation must take into account the stability of the fracture, as well as the type of fracture management (operative, nonoperative), and must be guided by the treating physician.

In order to decrease pain, local cold application may be beneficial. Edema, a common problem, may be controlled using modalities such as cold packs (Salter) and compressive wrapping. To prevent complications of inactivity, individuals should be encouraged to continue functional activities that do not compromise the status of the fracture.

Non-displaced fractures may progress to weight bearing after 4 to 6 weeks (Easley). Because residual impairment is common with displaced fractures of the talus, these are usually surgically repaired (Easley). If the fracture required surgery, the treating physician will dictate the rehabilitation protocol.

When appropriate to return the individual to functional activities, gait training using appropriate assistive devices is indicated to promote independent ambulation. Therapists should instruct the individual to progress from walker to crutches to cane according to his or her ability and weight bearing status. If the ankle is splinted or casted, range of motion exercises of the adjacent joints may be beneficial unless contraindicated based on fracture stability. After splint or cast removal, range of motion, proprioceptive, and strengthening exercises should be started at the ankle and forefoot. Exercise intensity and difficulty should be progressed until full function is evident.

Bone healing may occur within 6 to 12 weeks; however, the bone strength and the ability of the bone to sustain a heavy load may take up to several years (Chapman). Once healing has occurred, the individual may resume activities of daily living. It is important to instruct the individual not to overload the fracture site until the bone has regained its full strength. The resumption of heavy work and sports should be guided by the treating physician.

Additional information may provide greater insight into the rehabilitation needs of these individuals (Fortin; Thordarson).

FREQUENCY OF REHABILITATION VISITS
ClassificationSpecialistTopicVisit
Nonsurgical Physical TherapistFracture, TalusUp to 16 visits within 8 weeks
SurgicalPhysical TherapistFracture, TalusUp to 12 visits within 6 weeks
Note on Nonsurgical Guidelines: Rehabilitation may not begin until tissue healing, about 6 to 8 weeks after the fracture.
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