Greenberg S N, Bello R P
Best Associates, Injury Management and Prevention Services, Pelham, NY 10803, USA.
J Orthop Sports Phys Ther. 1996 Jul;24(1):37-45. doi: 10.2519/jospt.1996.24.1.37.
Billions of dollars are spent annually for the costs associated with workers' compensation cases. Chronic low back injuries have been traditionally the most costly cases. In addition to the physical problems, psychosocial issues emerge which confound conventional treatment and prolong resolution. Work hardening programs were developed to address the many issues of the occupationally injured chronic patient. This case study examines the treatment of a 54-year-old male who sustained an injury to his lumbar spine during employment as a boiler mechanic and subsequently had been out of work for 8 months. The article describes the interdisciplinary work hardening treatment (5-week duration) and the progressive resistive work circuit which preceded the client's return to work. It is concluded that work hardening programs can be cost-effective for insurers, as in this case, saving an estimated $44,000. An aggressive return to work program should also be considered in earlier stages of injury as a way of preventing the development of chronic disability for which the human costs are immeasurable.
每年花费数十亿美元用于与工伤赔偿案件相关的费用。传统上，慢性腰伤一直是成本最高的案件。除了身体问题外，还出现了社会心理问题，这些问题使传统治疗变得复杂并延长了康复时间。工作强化计划旨在解决职业受伤慢性病患者的诸多问题。本案例研究考察了一名54岁男性的治疗情况，他在担任锅炉机械师期间腰椎受伤，随后失业了8个月。文章描述了跨学科工作强化治疗（为期5周）以及在客户重返工作岗位之前的渐进性抗阻工作循环。得出的结论是，工作强化计划对保险公司而言可能具有成本效益，如此案例所示，估计节省了44,000美元。在受伤的早期阶段也应考虑积极的重返工作岗位计划，以此作为预防慢性残疾发展的一种方式，而慢性残疾的人力成本是无法估量的。
