TV 367: Physiotherapist`s role in facilitating return to work after sick leave absence (English Subs

زنگ سلامت 367
TV 367: the physiotherapist`s roles in facilitating return to work after sick leave absence (English Subtitles)
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Hello to all our dear audience I’m here with another episode of Zange Salamat and as always, I wish all of you are healthy at the beginning of the episode unfortunately, it’s never enough giving information and knowledge about health management as people around the world and especially in our country

They don’t have sufficient access to this information and some of them don’t care about health management and therefore, they’re in danger of diseases and complications in that case, their everyday life is hugely influenced by that disease if you haven’t had a disease or injury so far

There may be a few health matters which you have missed and not paid enough attention to for instance, one of these matters is returning to your work and daily life activities which is the matter of discussion for today it’s about how and under what circumstances it’s possible to return to the work environment

After a prolonged period of disease and dealing with a complications which can potentially cause you discomfort for a few months easily and sometimes it takes a few years for a person to return to their work environment well, in most cases many diseases have a sudden onset for instance

A person falls and breaks their arm or leg as well as car accidents unfortunately, there’s a high rate of car accidents in our country so I hope until the day that responsible authorities take power you dear people are careful while driving and be assured that with complying with related principles

You can prevent any casualties to yourself and others and also take good care of yourselves Because a simple car accident could possibly cause many problems for a number of people or another example can be somebody waking up in the morning and they feel a severe low back pain which causes many limitations

Beside this, there are diseases related to internal organs and cardiovascular complications and neurologic problems and sometimes we have musculoskeletal complications Such as a meniscus tears in knee or ankle sprain these problems won’t let you climb down the stairs of your home easily you can’t even walk properly in the first few weeks

And the consequences of these problems especially if the injury is severe or the disease has a devastating nature the only solution is to stay inside and rest at home in the first few days a few days of rest can unintentionally become a few months or even years of rest

And the reason for that can be due to the disease severity improper treatment or the post-injury psychological and mental problems for instance, an approximately 50-60 year old person or even younger, 20 or 30 year old persons they may suffer from traumatic brain injuries due to accidents or without a clear reason

In some cases, vascular complications could lead to stroke or the people who suffer from cardiovascular problems they experience a huge amount of mental pressure after that injury or disease which entraps them in a vicious cycle and this cycle could last up to a few months to a few years

And this means impaired ability to perform regular daily activities in addition to causing economical problems for the family not going out and to work after a few weeks can make you less motivated and in some severe cases even depressed it can make you feel unhappy

And since the body loses its adaptations to work and do physical loading mostly the timing of returning to work is delayed for a few weeks one of the experts that help with the return to work after a prolonged period of disease is a physical therapist

My physical therapist colleagues play an important role in helping the patients get back to their previous level of work of course it’s clear that the techniques and advices performed verbally, manually and with exercises they are very important and that’s why in addition to a physical therapist responsibility

The role of his or her knowledge and awareness of applying appropriate techniques to help with work return is important as well I’ve had dozens of patients like this in every month and year I had this 28 year old Australian patient I’m still in contact with him he’s a good person

Unfortunately due to a low back pain, he has been away from his work for nearly a year he had a good job in a bank he was one of the bank clerks and as I’ve said, he entered the vicious cycle so what’s this vicious cycle? the patient suffers from a specific disease

And normally, has to rest for a couple of days and when he enters the immobilization and rest cycle, due to inadequate work, exercise and activity and delayed initiaton of proper improvement in appropriate timing this vicious cycle starts and in the next weeks and months

Due to the depression and the chronic pain which comes with chronicity of the disease the patient will lose their passion of returning to work and this is where physiotherapists play an important role I started talking with my patient after the first two sessions

About the fact that he must get prepared to return to work because eventually he’ll be able to get back to work again with applying dozens of therapeutic techniques based on individual’s profiles and character traits Look my friends, every person has their own unique characteristics

And in physical therapy we take actions based on these features specifically based on behavioral cognitive therapy and based on any individual’s unique traits, we’ll design our techniques Such as using encouragements and different specific behaviors until my patient got prepared

And one session he asked me with passion about whether he could return to work or not and I strongly said “Yes” you can go to work from tomorrow he hadn’t gone to work for six months but now he has returned to work with passion

And the interesting thing is that when he went back to work he was very happy and he enjoyed it a lot and he said that it felt like he had lost something in his life and this is the truth honestly when you don’t go to work

Well it’s true that in modern countries, in these situations, a patient’s salary is paid by the government due to the sickness since they’re unable to work not working will devastate your spirit and passion how long can you sit at home and do nothing?

How long can you just walk the alley and come back home? when you go to your work you’re busy working you’re busy talking with your colleagues it’s a solution itself which helps you recover rapidly I have another female patient who still comes here she had brain injury, a case of Stroke

Her left side of body was injured it wasn’t severe and fortunately, after a few weeks of rehabilitation she reached a level of function which allowed her to walk independently and do her personal things at home she is hired in a big company and she works there

And when I told her that she’s ready to get back to work she was surprised and told me if I was being serious and I said “Yes” you are ready but of course, you can’t just send them to their work so quickly there are many factors which I’ll discuss

There’s a process that takes a few weeks for a physical therapist to prepare them mentally to return to work so she got back to work she worked part-time at first for twice a week and two times half a day then we made it four times a week each day for half a day

Then we made it five times a week and then we made it twice a week with full-day work and now she goes to work five times a week with full-time job it wasn’t easy to get her to reach this level my friends the patient usually experiences difficult times during this period

And they don’t have patience for this many of them, especially in European countries since they’re being paid by the government they’re like “why should I even work anymore”? but the point is that not going to work can cause the disease to get worse not only physically, due to being physically inactive

But also mentally, it harms them as well for instance, in Covid times, many people didn’t go to work and all of you experienced this even if the people who use taxi, trains and buses to get to work they will still walk the distance between home to taxi or train station

They climb a few stairs in the metro or bus station getting on and off the train walking the rest of the distance to their work walking the stairs in the work environment they have many break times they’ll move and walk again they go to the kitchen and eat lunch

When you take a look at somebody’s woking hours you’ll see that there were thousands of steps taken in a day of work so if they didn’t go to the work In the Covid times, all of these disappeared So therefore beside constantly thinking about their jobs

As they’re working on a project or doing a job either manually or mentally demanding jobs there are a few tasks for instance, working behind a computer they still have some form of activity beside that, they are constantly communicating with their colleagues the transportation being in the taxi, bus and train

The conversations and talks so instead of being in the home and thinking about their disease and increasing their depression and stress, those are replaced by something else and this is proved by research as well that returning to work must the priority for all the health care professionals

In fact, all the experts in the field of medicine are responsible to prepare their patients to return to work so in case a doctor or a physical therapist or an occupational therapist they’re all helpful in preparation of patients on their return to work when you visit a doctor or expert

And they don’t address this matter themselves or they don’t care about discussing it you have the right to ask for their guidance as it is your right if they don’t know about it make them go and do research about it to get information about it

And make them search a couple of related things about it or ask them to introduce you to somebody who can actually help you on this because it’s not an easy job if someone has low back pain and they can’t walk because of it you can’t send them to go to work that’s wrong

When someone has a severe meniscus tear and they can’t climb up or down the stairs because of it if you send them to their work they must use an assistive device like a cane anyways, there are different techniques and ways and for every patient based on their specific disease, strategies are different

Therefore, things are a little complicated and you certainly need an expert’s guidance and help as I’ve mentioned, physiotherapists play an important role in this matter because not only will they help with your recovery process they will prepare you to return to work with different techniques

Now let’s take a look at the factors involved in helping a patient get back to work one of them is the improvement of the disease some diseases are improved to a certain extent while some others are improved fully and some of them may improve very slowly

But it’s possible to make some suggestions for every condition and to find an alternative way to help the patient return to work for instance someone has a low back pain and he is suffering from it for two years this complication can be improved fully with physiotherapy

We can make him reach a level of function that makes him able to return back to work in some complications like a meniscus tear the patient goes to physical therapy, and they haven’t gone to work for two months you run a full rehabilitation program for them but they won’t get better

And they haven’t got back to their work yet so there’s no solution left but to seek surgery so they’re adviced to seek surgery same thing goes for back and neck pain for any musculoskeletal disease we try to treat it first if it’s not treated, we refer them to other experts

But, we imagine that the improvement is complete up to 50, 60 or 70% at that point, we can discuss about the matter of returning to work because it doesn’t occur to them most of the time and most of the time, they don’t even want to think about it

And then based on a few questions such as the their work status and their feeling and mood towards returning back to their work considering these matters, after 60-70% improvement is completed we must bring this matter up and prepare the patient in a few sessions

In order to return to work as part time or full time job and beside all these, some actions must be taken to prepare the patient for instance a stroke patient who has hemiplegia, this complication shouldn’t be an excuse to stop her from working if it’s necessary, use a cane or crutch

If it’s necessary, use a splint or brace use some specific shoes designed by orthosis and prothesis experts if it’s necessary, specific vehicles designed for stroke patients can be used such as automatic gear cars according to the underlying conditions when improvement is made up to 50, 60 and 70% evaluate the patients work environment

Does it have stairs? or not? how does the patient get to work? do they use a car? do they use a train? do they walk? or do they use a taxi? or somebody drives them to the work and pick them back home consider all of these, and consult with your patient

And then you can make coordinations if it’s necessary, send a letter to their boss in the office if it’s necessary, you can ask for a wheelchair if it’s needed if someone has a spinal cord injury, it shouldn’t stop them from working because avoiding work can disturb their mental health

So based on the patients conditions and their work environment there will be some actions taken in order to return them to their work a very important matter to be said as I’ve mentioned it is the cognitive behavioral therapy which can be done by physical therapists the behavior therapy

And I’ll certainly arrange a program for this matter with the help of a psychologist or by myself because cognitive behavioral and functional therapy has a high value in physical therapy all the patients who suffer from a disease for a few months they will experience depression and their mental health will be altered

And that’s a main problem which decreases their motivation to get back to work and we need to work on it many people experience chronic pain syndromes due to fibromyalgia we must consider every aspect of This patient’s life including their work conditions

Some complications can cause a person to change their job and find a new one because they can’t continue their previous job with the current disease so there are many solutions here the transportation to work and the preparations needed in the work environment maybe somebody needs a special chair in their work environment

So based on the letter sent from the physiotherapist to the boss of that person in the bank or office a new chair will be bought for that patient or some adjustments needs to be made on the desk or they may need to change their computer to a Lap top of vice versa

There maybe adjustments needed in work environment lightning based on the conditions present by the disease there might be adjustments and coordinations needed in order to return the patient back to work from ergonomic changes and adjustments in work environment physiotherapists can take actions upon these matters if it’s necessary

We can go to the work environment of the patient ourselves to check and see the deficiency of facilities needed to return the patient back to work environment so we could make proper suggestions another important matter is the continuity of treatment of the patient for instance in a stroke patient with left hemiplegia

And they won’t make full improvements there are many exercises to do and continue with strengthening the tissues to make them continue doing their jobs or for a person with prolonged low back pain or Fibromyalgia cardiovascular issues the patient can maintain their function in the work environment with consistent, proper and appropriate exercises

This was the last matter i wanted to talk about returning the patient back to work is a separate matter from maintaining the patient functionally in the work environment which is an important matter in order for the patient to communicate with their colleagues and to be active in the work environment

And also stop the disease from getting worse So physically, we need to maximize the function of the patient if the improvement can not be fully achieved we must make them reach a level of 50, 60 or 70% improvement or help them as much as possible to prepare them physically and mentally

With the help of advices we give them so the patient’s passion to work can return and go back to the work environment now if it’s necessary, they can work for four hours per week or 40 hours or as much as they can tolerate and for maintenance of the patient in the work environment

Some patients may need to visit their physiotherapist every week or month to gain more advices and instructions and most importantly is the strengthening of the whole body my Friends every disease has the potential to weaken the body so with proper strengthening, we can keep the patient working in the work environment

So, my friends who are suffering from a disease even after you’re improved visit your physical therapists every month or two gain the related advices and instructions from them if you’re living in London I’m at your service I hope you’re always happy and healthy returning to work must be your priority all the time

Do not rush the process, if it’s necessary, rest for a week or four or even for two months but when you’re fully ready, you should not wait anymore you must return back to your work to make your improvements complete I hope this episode was useful to you please visit our social media

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Have a good day, farewell