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.

Repair (Reconstruction), Anterior Cruciate Ligament


Related Terms

  • ACL Reattachment
  • ACL Reconstruction

Specialists

  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist

Comorbid Conditions

Factors Influencing Duration

Work requirements, complications, and inability or unwillingness to participate in a rehabilitation program will affect length of disability. Associated injuries and treatment will also affect the duration of disability. Activities stressful to the knee must be avoided. If job duties can be performed while sitting, duration may be shorter.

Medical Codes

ICD-9-CM:
81.45 - Repair of Anterior Cruciate Ligament, Other

Rehabilitation

Rehabilitation, requiring months of intense exercise, is recommended for successful recovery from a surgical repair of the anterior cruciate ligament. Rehabilitation following ACL repair follows a structured process beginning immediately after the surgical repair and ending with the individual returning to work and other activities. The entire process can take up to 6 months. Accelerated programs are now preferred, as earlier active knee extension does not appear to cause ligamentous laxity later (Amy).

Initially the physical therapist uses modalities, such as cold packs, to decrease postoperative pain and swelling. The physician may request very gradual weight-bearing immediately after the ACL repair. A rehabilitation brace, also called a postoperative brace, is typically used immediately after surgical repair.

Once pain and swelling are controlled, knee range of motion is started in rehabilitation and performed as tolerated, and as guided by the surgeon. Ankle range of motion of the involved lower extremity should be encouraged intermittently throughout the day to promote blood circulation. By the end of this phase, crutch walking should be easily tolerated.

At the end of immobilization, when swelling is controlled and pain is minimal, active assisted flexion and passive extension may be performed along with quadriceps strengthening exercises (Amy). Goals of rehabilitation are to achieve full and pain-free motion of the knee joint along with strengthening of, in particular, the quadriceps and hamstring muscle groups, and all muscles in the involved leg. Aquatic exercises may be useful (Amy).

When there is no swelling, minimal to no pain, and almost full range of motion, the individual is encouraged to walk, with weight bearing restrictions as indicated by the surgeon, and may be allowed to return to light work. More intense exercising, with increased resistance, is called for during this phase. Cycling and proprioceptive exercises may be attempted at this time. Resisted exercise as guided by the therapist includes closed kinetic chain exercises and progresses to sports-specific training with the use of a brace (Amy). The individual is instructed in a home exercise program during each phase of the rehabilitation process.

The individual's reinstatement to work as exercise is now directed toward work requirements. The physician may prescribe a brace to be worn by the individual at the onset of resuming functional activities, and when the individual returns to work, training, or competition. However, evidence does not support using braces either in the short term (immediately after surgery) or the long-term to improve ACL reconstruction outcomes (Kruse).

Generally speaking, rehabilitation of the anterior cruciate ligament will vary depending on the type of surgery that was performed, the location from which the graft was harvested, and whether any associated supporting ligament and cartilage were also injured and/or repaired.

FREQUENCY OF REHABILITATION VISITS
Surgical
SpecialistRepair (Reconstruction), Anterior Cruciate Ligament
Physical TherapistUp to 24 visits within 26 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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