OTs offer a range of services that may assist with injury management, including:

• Designing graduated return to work programs;
• Manual handling programs;
• Functional capacity evaluations;
• Rehabilitation case management;
• Application of ergonomic principles;
• Risk assessments; and
• Pre-employment screenings.

WHAT ARE THE STRENGTHS OF THE OT APPROACH?

A positive spin

Rather than concentrating on limitations that result from workplace injury or illness, OTs are likely to focus on maximising the individual’s capacity to resume activity. In other words, OTs focus on ability, not disability.

Helping or hurting?

Both doctors and supervisors / line managers can struggle to identify suitable duties, because the former lack knowledge of the workplace, and the latter lack a medical background. OTs can bridge this gap. They are skilled in task analysis and capable of identifying not only what aspects of duties might aggravate a health problem, but also what aspects of duties will bring benefit.

Maximum movement

Because workplaces may lack the capacity to assess the extent to which a particular movement is helpful or harmful, they may err on the side of caution. This means that RTW programs are often movement-avoidant, which has negative consequences for recovery. OTs understand medical information and are also able to see and assess the demands of the work. Therefore, OTs can help design programs where workers are doing as much movement as it is safe for them to do—and this has proven benefits.

Improving the system

OTs may be able to identify the challenges facing a particular injury management system, and offer practical advice. OTs tend to focus on:

• Increasing the amount of communication;
• Ensuring that all stakeholders are working towards a clear, common goal; and
• Thoroughly reviewing how and why the injury occurred in the first place, which promotes safety and increases morale and commitment to the RTW process.

If a significant hole in the injury management system is identified, an OT might:

• Recommend that the employer seek out of a specific expert (e.g. a psychologist);
• Recommend that the employer sets up a particular program; or
• Help fill the gap (e.g. by writing a functional description of jobs to send to doctors).

Ergonomics expertise

OTs are trained in the assessment of environment and equipment and individual’s interactions with both of these things, often referred to as ergonomics. If a piece of equipment could be modified or purchased to improve occupational health and safety, OTs are able to assist in identifying that.

For example, a common problem is that people using a computer based workstation might keep papers on the desk to the left hand side of their keyboard. Looking down while typing keeps them in an asymmetrical position where some muscles are flexed and others are over-stretched. This is likely to cause musculoskeletal problems. So the OT might advise a sloping work surface for documents, to be kept between the keyboard and monitor. This will lead to more symmetry and better posture.

Early intervention

If they encounter someone who has to bend over all the time, for example a mechanic, an OT might notice that they are bending with poor spinal posture, and understand that this is because they have tight hamstrings. The OT could then teach this individual some hamstring stretches to lengthen their muscles, and eventually they would be able to bend from the hips, keeping the back posture.

Risk assessment

OTs can help with risk assessment, considering factors such as:

• Physical requirements of role, for example lifting, carrying, detaining people etc;
• Running on slippery surfaces;
• Diet / weight;
• Ageing workforce;
• Manual handling;
• Rolling stock / things on wheels;
• Rails trip hazards;
• Stress;
• Work hours;
• Supports;
• Mentoring; and
• Induction.

Occupational Therapy Australia operates the Accredited Occupational Therapist Program (AccOT), which you can access here.

Thanks to Sven Rohr, who gave us the low down on OTs.