1) Goal Of Work Hardening a) The ultimate goal of work hardening is to help the client achieve a level of productivity that

is acceptable in the competitive la-bor market. 2) Productivity improvement is achieved through the following techniques a) Decrease in secondary impairment effects. Impairment is often magnified through disuse. Work hardening improves strength, flexibility, and endurance. b) Decrease in functional Limitations, helps the client learn effective adaptive behaviors. c) Decrease in disability. Helps client decrease work-related disability d) Improvement of vocational feasibility Work hardening identifies and remediates potential problems with productivity, increases safety in the work place, and strengthens interpersonal relations. e) Improvement of employability related to the clients work tolerance(ability to lift, carry, and stand) in comparison with the tolerances of other workers in the general labor market. 3) Work Hardening Program Characteristics a) Takes place in a nonhospital environment typically. b) 600-1500 Square feet c) Work Capacity evaluation devices as the primary treatment tools d) This allows the work hardening professional to present the patient with tasks that simulate job tasks and that can be graded in terms of the level of difficulty or length of time involved. 4) Evaluation process a) A clear diagnosis and specific work restrictions must be available from a physician. b) Intake interview is conducted i) Review of clients medical status ii) Functional Tolerance information is collected iii) Functional Tolerance profile which is a review of work-relevant abilities based on the activities of daily living. iv) Design the individual work hardening plan 5) Stage Model of Industrial Rehabilitation a) Stage 1 Pathology Study of tissue and bone b) Stage 2 Impairment Evaluation of Anatomy Physiology, and Psychology c) Stage 3 Functional Limitation Patients report of symptoms and limitations. Observation of Function d) Stage 4 - Disability Social consequences of the functional limitations; how they affect the patients customary roles e) Stage 5 - Feasibility Acceptability of the patient as an employee. Work behavior of the patient. f) Stage 6 - Employability Ability to become employed within a particular labor market g) Stage 7 - Vocational handicap Ability to become employed in a particular occupation h) Stage 8 Earning Capacity Income measured over the workers lifetime.