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.

Rehabilitation Therapy


Related Terms

  • Cognitive Therapy
  • Occupational Therapy
  • Physical Therapy
  • Recreational Therapy
  • Speech Therapy
  • Vocational Rehabilitation

Specialists

  • Chiropractor
  • Neurologist
  • Occupational Therapist
  • Oncologist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist
  • Psychiatrist
  • Pulmonologist
  • Recreational Therapist

Comorbid Conditions

  • Alcohol or substance abuse disorders
  • Cancer
  • Obesity
  • Psychiatric disorders

Factors Influencing Duration

Because there is no disability associated with the rehabilitation therapy itself, the only factor influencing the length of disability involves the underlying condition that prompted therapy. This factor will require evaluation on a case-by-case basis.

Medical Codes

ICD-9-CM:
93.81 - Recreation Therapy; Diversional Therapy; Play Therapy
93.82 - Educational Therapy; Education of Bed-bound Children; Special Schooling for the Handicapped
93.89 - Rehabilitation, Not Elsewhere Classified

Overview

Rehabilitation therapy comprises various treatments aimed to increase functional independence, prevent further loss of function, and maintain or improve quality of life for individuals living with physical illnesses or conditions. The desired outcome is to enhance the individual's independence in as many aspects of life as possible, including activities of daily living, work, and family responsibilities. There are many different types of rehabilitation therapy, including occupational, physical, speech, respiratory, recreational, cognitive/psychological, and social services therapy.

Occupational and physical therapists employ meaningful work and self-care tasks to help individuals regain functional mobility, strength, and range of motion. Speech therapists promote effective communication and swallowing. Respiratory therapists work to maintain a clear airway and decrease respiratory distress. Social workers facilitate rehabilitation through careful discharge planning and coordination of ancillary services. Recreational therapists work to improve socialization and community reintegration. Psychologists and psychiatrists help to decrease depression, maintain motivation, and set realistic expectations for recovery. All rehabilitation therapists strive to promote functional independence and to prevent further disability.

Rehabilitation therapy may be used pre-operatively to improve strength, flexibility, endurance, and coping strategies. Rehabilitation may also be used postoperatively to assist in recovery from a variety of conditions. Therapy may help with rehabilitation after an acute condition such as stroke or in more chronic conditions such as arthritis. Therapy interventions should involve family members in the coordination of care to maximize an individual's functional gains.

Rehabilitation therapy may be conducted in five major types of settings, including inpatient acute care hospitals, inpatient rehabilitation units, outpatient clinics, skilled nursing facilities (with or without a subacute unit), and the individual's home (home health care).

Source: Medical Disability Advisor



Reason for Procedure

Rehabilitation therapy helps individuals recover from a disease process or surgical procedure. Individuals attend therapy sessions that are tailored to their functional limitations and geared toward independence in self-care. Once functional limitations are identified, the disability level of an individual is reduced through mobility training, activities of daily living training, general conditioning, and vocational counseling. The ultimate goal is to help individuals resume independent participation in work and family life.

Source: Medical Disability Advisor



How Procedure is Performed

Functional rehabilitation should be the basis and goal of all best practice techniques. Physicians, social workers, or case managers may refer individuals for specialized rehabilitation services in outpatient, home, or inpatient settings. During prescreening or after referral, therapists evaluate the individual to assess physical and cognitive ability, the overall degree of disability, and the indications for specific types of therapy. A team of appropriate rehabilitation specialists then develops a comprehensive program tailored to the individual's needs. Minor orthopedic conditions such as ankle sprain may only require physical therapy, whereas spinal cord injury requires a complete team of rehabilitation specialists.

Occupational therapists help an individual to adapt work and home activities by ordering adaptive equipment as needed to facilitate independence and by teaching individuals to conserve energy while performing activities of daily living. Therapists may also instruct individuals in activities that promote fine motor coordination.

Physical therapists help the individual regain functional mobility, strength, proprioception, and range of motion through activities such as balance training, gait training, and exercise programs to stretch and strengthen affected areas of the body. They instruct in body mechanics, postural retraining, and ergonomics. Physical therapists may also order assistive devices as needed to promote independent mobility.

Speech therapists (speech-language pathologists) promote effective communication by strengthening mouth and throat muscles associated with the production of speech and by improving articulation. They may order communication devices for those individuals who are unable to communicate vocally. Speech therapists also promote the ability to safely chew and swallow food through the use of different food textures and exercises designed to promote salivation and sucking, and reduce the gag reflex.

Cognitive-behavioral therapists use mental exercises to improve return of function following head injury, encephalitis, or other nonprogressive neurological condition affecting memory, language skills, reasoning, and other thinking skills.

Respiratory therapists teach breathing exercises and perform chest percussions to decrease chest congestion and increase the volume of inspired air. They may also instruct individuals in the use of supplemental oxygen and inhalers.

Social workers address the needs of individuals and their caregivers by providing psychosocial support and ensuring that adaptive equipment, community-based meal preparation programs, and spiritual support are in place before discharge.

Recreational therapists facilitate return to the community by helping individuals build confidence and improve socialization through activities and community outings.

Psychologists and psychiatrists provide counseling to individuals who face disability. Vocational counselors work with individuals to prepare them to return to work and to redirect individuals to alternative employment if physical impairment prevents a return to their original occupation. Vocational rehabilitation helps individuals learn job skills that will be needed in modified or new employment positions.

Source: Medical Disability Advisor



Prognosis

The therapeutic outcome varies, depending on the diagnosis, the severity of impairment, the individual's motivation and social support network, and any comorbid conditions. Therapeutic outcomes are generally good for individuals with acute, self-limited impairments, such as simple sprains and strains, or for more chronic but mild impairments. Individuals with severe or multiple deficits may have a more variable outcome from therapy. In some cases, spontaneous recovery may continue to occur well after therapy is complete.

In general, rehabilitation therapy allows faster recovery than is expected in the absence of rehabilitation. Rehabilitation therapy should be explored early for acute injury to prevent the need for ongoing services that may require the deployment of greater resources and, in some musculoskeletal cases, to avoid the need for surgery. For individuals with complicated diagnoses such as stroke or spinal cord injury, rehabilitation is crucial to any recovery of function. Depending on the injury, many individuals return to most of their customary activities either independently or by using adaptive equipment.

Source: Medical Disability Advisor



Complications

If therapeutic exercises are too difficult based on the individual's level of function, resulting injury could complicate rehabilitation. Poorly fitting or inappropriate orthotics, wheelchairs, or other adaptive equipment may lead to pressure sores or other injury. Inappropriate lifting or other physical tasks could lead to injury in vocational rehabilitation. Depression may complicate rehabilitation of any type, once the individual confronts his or her degree of disability and acknowledges his or her limitations. However, depression can be avoided by ongoing counseling, support, and encouragement. Recovery may be hindered by lack of family or social support, or by litigation, workers' compensation claims, or other situations fostering the sick role. Learning difficulties (as seen following stroke or head injury) may hinder progress in rehabilitation due to poor follow-through with instructions.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Work restrictions or accommodations are generally determined by the underlying condition, not by the rehabilitation therapy itself. If outpatient therapy continues once the individual returns to work, time off or flexible scheduling may be needed.

Source: Medical Disability Advisor



References

General

"What is Occupational Therapy?" American Occupational Therapy Institute. 24 May 2005 <http://www.aota.org/featured/area6/>.

Source: Medical Disability Advisor






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