Case Study - Sarah

Exercise Physiology Intervention
 

Sarah is likely to have been referred to KT KINETIC by her medical team. 

As her injury occurred at work, she will be onboarded through the Workers Compensation pathway. 
Sarah will likely have a case manager, sometimes referred to as a Vocational Rehabilitation Provider.

She may also be working with other allied health professionals, such as a physiotherapist.

 

Ongoing communication with this interdisciplinary team will be fundamental to the service I offer as an EP

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An initial assessment will be completed with Sarah.

As I operate a mobile business, a private room will be hired to complete some elements of this baseline assessment. 

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In the initial assessment, I will complete an extensive range of testing with Sarah. 

This will include objective measurement of her range of movement, strength, and functional capacity. 

It will also include subjective measurement, in this case, via completion of the OSWESTRY - Low Back Pain Disability Questionnaire.

 

Upon completion of this assessment, I will have baseline data indicating her current levels of function.

I will also have a good understanding of the physical demands of the job that she is trying to return to.

My clinical experience will be called upon to develop a rough timeline giving key stakeholders an estimation of her rehabilitation needs. For Sarah, this will serve to give her a better idea of the path ahead. 

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From here, an exercise intervention will be formulated. It might look a bit like this:

 

Establish a home program that can be completed daily- short and effective- mostly based on mobility and core strength.

Then...

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For the first 8 weeks -

Twice per week hydrotherapy sessions

• A low-impact way to regain some of the strength and mobility lost whilst in a brace

• A good opportunity to develop a routine that prioritises her recovery and rehabilitation

• Regular sessions will promote adherence

 

8 to 16 weeks - 

1x per week hydrotherapy  |  1x per week gym-based strength and conditioning

• Graded progression of strength-based exercises with the primary goal of facilitating Sarah's global recovery

• Re-introduction to more demanding movement patterns such as lifting, bending, squatting, pushing, pulling, rotating

• Maintain and improve cardiovascular fitness, and weight management if applicable

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16 to 28 weeks -

2x week gym-based strength and conditioning. 

• Ongoing progression of strength-based exercises

• Programming focused on the demands of Sarah's pre-injury role and building her capacity and endurance for these tasks

• In this case, examples might include working in awkward or unusual positions; overhead, kneeling, squatting, climbing etc 

• Lifting restrictions are likely to have been placed on her by her medical team, my role is to supervise her in testing these out

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28 to 52 weeks (or as long as is medically indicated) 

1x per week  |  1x per fortnight   |  1x per month

• With time, Sarah may begin to complete some of her rehabilitation sessions in a 'self-managed' capacity

• This will result in a decreased frequency of her 'supervised' sessions

• Intermittent supervision will still be indicated to alter and progress her program

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Return to work 

Whilst some people may be permitted to return to their job under modified or 'light' duties, others may have to reach full capacity first. Every case is different. 

 

It is likely that Sarah must have full capacity prior to returning to her role as a rigger. 

In such cases, it is not uncommon for the Vocation Rehabilitation provider to arrange a 'work trial' in which the person can work elsewhere, slowly testing out their functional capacity.

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My role as an EP will include advocating for Sarah, and ensuring that her rehabilitation is prioritised.

This includes maintaining an accurate sense of the 'big picture' and includes regular communication with all key stakeholders. 

Sarah will be excited to see progress and regain her function, but managing her overall workload is integral to her success.

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It is important to remember that rehabilitation from an injury is never linear

There will always be ups and downs; good days and bad

Helping a client to manage their overall workload, is essential to their recovery

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"Peaks & Valleys" - Mark McMorris (Professional Snowboarder)

"Progress isn't about a steady climb upward. There are ups and downs, and stagnation. That's the nature of change."- Michelle Obama 

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