Work Hardening/Conditioning

I visited a work hardening/conditioning site today and it was so interesting. In a nutshell, work hardening is occupational therapy that focuses on returning a person to work. Treatment focuses on mimicking, as much as possible, a client's job duties and work environment.

This facility was wonderful. Some things I noticed are

• streetlights (yes, a real streetlight, truncated of course)
• tall and short ladders
• nuts and bolts for screwing on and off on a high or low board
• bags of true-weight cement
• garbage cans
• buckets to simulate the weight of paint buckets
• vacuum cleaners
• shovels
• inclines and declines
• gravel
• carts for pushing and pulling
• carpet for friction
• a dummy in a wheelchair
• a plumbing setup
• scaffolding
• all sorts of boxes of various weights
• stairs
• and even a simulated bus/truck driver unit. I got in this unit and it moves and feels just like a truck/bus. It has a clutch, gears, and a TV to simulate driving on the road.

They also have a machine called the BTE or Baltimore Therapy Equipment which is basically a machine that simulates all kinds of real world movements for job function or personal interest. You can set the machine for appropriate resistance and to mimic the motion. For example, I was told the story of a woman who said she'd love to be able to ride her Harley motorbike again. They showed me a piece that looks kind of like a wrench. It was attached to the simulator and when I gripped and squeezed it, it had the weight, feel and resistance of a motorbike clutch! The machine requires that you continue to grip it and maintain the same force with each grip. It records your grip strength performance over time so the therapist can determine your rehabilitation progress.

The machine can do hundreds of simulations but some that I noted were:

• shoveling
• operating a drill press
• turning a knob
  
• using a screwdriver
• turning a key
• climbing a ladder (amazing!)
• sweeping the floor
• shoveling snow
• sanding
• painting
• steering a whel
• gripping
• vacuuming

The work hardening environment is good for all the movements needed in a job that people don't think about--kneeling, stooping, crawling, reaching, climbing, balancing, lifting, pushing, pulling, carrying, scooting, etc. Finally, work hardening is therapy that mimics a workday where one participates for 6 or more hours and work conditioning is a half day, where one works for 3-4 hours.

Very interesting!