The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Treatments.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Rehabilitation Therapy of Treatments

Rehab (supervised formal therapy) needed after a work-related injury should be concentrated on regaining the functional ability needed to meet the patient’s daily and work obligations and enable them to return to work, to return the injured worker to their pre-injury status to the extent that the practical extent calls for the patient to put in an internal effort to finish a particular activity or assignment.

The procedures known as passive therapy rely on modalities that are administered by a therapist rather than the patient exerting any effort on their side. Passive therapies are typically seen to speed up an active therapy program and achieve concurrently quantifiable functional benefits. Over passive interventions, active initiatives should be prioritized.

To sustain improvement levels, the patient should be advised to continue both present and previous treatments at home as an extension of the therapeutic process.

To enhance functional improvements, assistive gadgets may be used as an adjuvant in interventions in the rehabilitation strategy.

1. Physical / Occupational Therapy

   Physical / Occupational Therapy is recommended to enhance strength and justification, including a range of motion.
   Frequency/Dose/Duration: The severity of the constraint often determines the frequency of visits. For the first two weeks of a fitness program, 2 to 3 visits every week are typical. For moderate individuals, the total number of visits might be as low as two to three, or as high as 12 to 15 if objective functional improvement was shown.

   Patients should be advised to continue both present and previous therapy at home as part of the rehabilitation plan to extend the healing process and sustain progress.

   Indications: people with neck injuries underwent surgery and were treated conservatively.

   Indications for Discontinuation: Pain, intolerance, lack of effectiveness, or disobedience are all resolved.

   Activities of Daily Living (ADL)

   Comings and goings of Daily Living include education, training with active assistance, and/or equipment or activity adaption.

   1. Activities of Daily Living (ADL)
      Activities of Daily Living (ADL) is recommended in a small number of patients, to increase a person’s ability to do everyday tasks including self-care, training for reintegration into the workforce, housekeeping, and driving.

      Frequency: Usually 3 to 5 times a week, with clinically justified effects appearing after four to five treatments over a maximum of six weeks.

   2. Aquatic Therapy
      Aquatic Therapy is not recommended.
   3. Functional Activities
      Practical Actions Interventions known as functional activities use therapeutic exercises to improve a person’s mobility, body mechanics, employability, coordination, balance, and sensory-motor integration.
   4. Functional Activities
      Functional Activities is recommended typically three to five times a week, with clinically acceptable results showing up four to five sessions, spread out over a maximum of six weeks.

      Frequency: in a few individuals, as clinically necessary

      Maximum Duration: 6 weeks

2. Functional Electrical Stimulation
   Functional Electrical Stimulation is recommended to certain patients.

   Indication: muscle weakness, atrophy, and slow muscle contraction brought on by pain, injury, neuromuscular dysfunction, or other conditions where atrophy is a possibility. Possibly an effective therapy when combined with a vigorous workout regimen.

   Frequency: typically, three times a week, with at least two months as clinically required and requiring two to six sessions to show results.

3. Neuromuscular Re-education
   Neuromuscular Re-education is recommended to certain patients.

   Indication: include the need to increase neuromotor response with autonomous control, to evoke and upgrade motor activity in patterns akin to typical neurologically established sequences, and to stimulate neuromuscular responses by precisely timed proprioceptive stimuli.

   Frequency: typically, three times a week, with an utmost of two months as clinically required and requiring two to six sessions to show results.

4. Therapeutic Exercise
   Exercises that fall under the category of therapeutic exercise include inertial, isotonic, isometric, and isokinetic forms exe exercise recommended in certain cases when clinically necessary

   Therapeutic Exercise is recommended in select patients as clinically indicated.

   Indications: Include the requirement for cardiovascular fitness, decreased edema, enhanced bone density, upgrade connective tissue force and durability, improved muscular strength, improved muscle recruitment, improved range of motion, and encouraged regular movement patterns. supplementary alternative exercise movement treatment is also possible.

   Frequency: typically, three to five times a week, with an utmost of two months as clinically indicated. Two to six treatments are required to produce an effect.

5. Electrical Nerve Block
   Electrical Nerve Block are not recommended
6. Electrical Stimulation (Physician or Therapist Applied)
   Electrical Stimulation (Physician or Therapist Applied) are recommended in a few patients as a part of an all-encompassing therapeutic strategy.
   Frequency – At the utmost of two months, do it twice or three times each week.

   Electrical Stimulation (Physician or Therapist Applied) are not recommended Like other passive methods, electrical stimulation is not advised as the sole mode of therapy.

7. Iontophoresis
   Iontophoresis are not recommended

   Manipulation of Treatments

   The therapeutic application of manually directed pressures by an operator to restore physiologic function and/or promote homeostasis that has been disrupted by the accident or occupational illness and has related clinical importance is referred to as manipulative treatment (not therapy).

   Abasement of cervical spine (neck region, vertebrae) dislocations imaret considered manipulation in this situation.

   Metastatic malignancy, severe osteoporosis, Joint instability, fractures, and infection, active inflammatory arthritides, and symptoms of increasing neurologic impairments, myelopathy, vertebrobasilar insufficiency, or carotid artery disease are all possible contraindications to manipulation.

   Stenosis, disc herniation, and spondylosis are examples of relative contraindications.

   1. Manipulation of Treatments
      Manipulation of Treatments is recommended is related to objective asses of betterment and there is no sign of a fracture or severe instability, for the treatment of acute and subacute neck pain. Patients with neck backbone joints stenosis require special attention.

      Frequency – As determined by the degree of engagement and the intended outcome, up to three times weekly for the first four weeks, followed by a maximum of 2 treatments in a week for the following four weeks, with reevaluation for signs of functional improvement or the need for more workup.

      For all manipulative therapy modalities, the time to effect is 1 to 6 treatments. The success of the treatment will rely on how well you are functioning.

      Optimum Duration: Two to three months.

      Maximum Duration: 3 months. In situations of re-injury, disrupted continuity of treatment, worsening of symptoms, and in patients with comorbidities, extended care periods beyond what is deemed “maximum” may be required.

   2. Manipulation of Treatments
      Manipulation of Treatments is recommended Following the diagnosis of MMI, a maintenance program of spinal manipulation (by a doctor (MD/DO), chiropractor, or physical therapist) may be recommended when linked to the improvement of functional status. (See Therapy: Ongoing Maintenance Care, Section D.10.)
   3. Manipulation of Treatments
      Manipulation is not recommended Treatment as a preventative measure is not advised.

      Rationale: There is no evidence to support the effectiveness of preventive therapy, either for primary prevention (before to the onset of the first pain episode) or secondary stopping (after amelioration from an episode of neck pain).

8. Manipulation of the Spine under General Anesthesia (MUA)
   Manipulation of the Spine under General Anesthesia (MUA) is not recommended.
9. Manipulation under Joint Anesthesia (MUJA)
   Manipulation under Joint Anesthesia (MUJA) is not recommended.
10. Massage (Manual or Mechanical)
    Soft tissue is moved during a massage (manual or mechanical), which has several benefits for circulation and relaxation. Acupressure, the use of suction cups, and methods like pushing, lifting, stroking, and squeezing of pulpy soft tissues by or with the professional’s hands may all be used to stimulate acupuncture points and acupuncture channels.

    There are several indicators, such as edema (peripheral or hard and non-pliable edema), muscular spasspasmshesions, the need to boost immaterial circulation and range of motion, o to rest and stretch muscles more before exercising.

    Massage must be combined with exercise and patient education, as is the case with other passive treatments. To continue treatment, an objective advantage (functional enhancement combined with symptom depletion) must be shown.

    • Massage (Manual or Mechanical)
      

      Massage (Manual or Mechanical) is recommended As an adjuvant to more effective therapies, notably a categorised aerobic and empowering exercise regimen, in the case of non-acute neck discomfort.

    • Massage (Manual or Mechanical) is recommended for both severe neck pain and persistent radicular disorders, which both have neck pain as a major symptom.

    • Massage (Manual or Mechanical) are recommended for individuals who do not have an underlying significant pathology, such as a fracture, tumor, or infection, and who just have non-acute neck discomfort.

      Frequency: Usually, once to twice a week, starting immediately, for the utmost of two months, if clinically necessary.

      Discontinuation: Efficacy, intolerance, or lack thereof.

    • Massage (Manual or Mechanical) are not recommended mechanical tools for giving massages.

      Mobilization (Joint) of Treatments
      The process of mobilization involves oscillatory vibrations applied to the cervical spinal passively (s). The passive mobility maneuver is carried out in a graded way (I, II, III, IV, or V), indicating the speed and range of joint motion. It could include expert manual stretching of joint tissues.

11. Mobilisation (Joint) of Treatment
    Mobilisation (Joint) of Treatments are are recommended in certain cases when clinically necessary

    Indications: Improved intracapsular arthrokinematics, improved segmental alignment, and the need to lessen discomfort brought on by tissue impingement are just a few examples. Active treatment should be used in conjunction with mobilization.

    Acute osteoporosis, joint integrity, breakage, infection, and symptoms of increasing neurologic deficits, myelopathy, vertebrobasilar insufficiency, or carotid artery disease are all contraindications to Level V mobilization. Spondylosis, Normal narrowing of a passage in the body, and disc herniation are examples of relative contraindications.

    Frequency: Typically, up to three times a week, with 6 to 9 treatments needed to see results, with four to thx weeks being ideal.

    Maximum Duration: one and half months/ about six weeks.

12. Mobilization (Soft Tissue)
    

    The expert use of muscular energy, strain/counter strain, physical trigger point running, and other physical therapy techniques is known as the mobilization of soft tissue. These techniques are intended to enhance or restore movement patterns by reducing discomfort and constraints in the soft tissues.

    These might be interactive in which the patient participates or passive in which the patient unwinds and allows the practitioner to manipulate the tissues of the body. Muscle contraction throughout a joint, trigger points, adherence, and neurological compression are symptoms. Active treatment should be used in conjunction with mobilization.

    Frequency: Usually up to three a week, it takes four to nine sessions to see results, and the best time frame is 4 to 6 weeks.

    Maximum Duration: one and half months/ about six weeks.

13. Short-Wave Diathermy
    

    Short-Wave Diathermy are not recommended

    Superficial Heat and Cold Therapy (Excluding Infrared Therapy)

    To reduce swelling, and pain, Sanford soon brought on by injury or activity, thermal agents known as exterior utmost cold, and heat are given a variety of ways to lower or increase the body’s tissue temperature. At specific acupuncture locations, heat is applied slightly above the skin’s surface.

14. Superficial Heat and Cold Therapy (Excluding Infrared Therapy
    

    Superficial Heat and Cold Therapy (Excluding Infrared Therapy) is recommended clinically appropriate in a subset of individuals.

    Indications: Include acute pain, edema, and bleeding. You also need to lower muscular spasms, improve stretching, and enhance your pain threshold. can be self-administered by the patient and used in combination with other active therapy.

    Frequency: Usually, as soon as possible and for a maximum of two months, as clinically required, two to five times each week.

    Optimum Duration: Three weeks as the main course of treatment or sporadically as an addition to other therapeutic techniques for up to two months.

15. Traction
    

    A crucial component of physical manipulation or joint mobilization is manual traction. Reduced joint space, muscular tightness surrounding joints, and an increased requirement for synovial nourishment and reaction are all indicators.

    Patients with tumors, infections, fractures, or fracture/dislocations should not undergo manual traction.

16. Traction
    

    Traction is recommended in some clinically warranted individuals with radicular symptoms.

    Indications: Usually, one to three times per week, with a topmost of four weeks as clinically required and one to three sessions needed to generate instant benefit.

    Optimum Duration: one month.

17. Traction: Mechanical
    

    Traction: Mechanical is recommended in some clinically warranted individuals with radicular symptoms.

    Indications: Patients with radicular signs are most frequently treated with mechanical traction. It is occasionally used to relieve symptoms brought on by tight muscles surrounding the joints and reduced joint space. If effective, it needs to be switched to home traction.

    Patients with tumors, infections, fractures, or fractures/dislocations should not use traction methods. If treatment is successful, a cervical traction device for home use may be acquired.

    Frequency: It usually takes almost three sessions to start working, two to three times a week on average, and up to four weeks as prescribed by a doctor.

    Discontinuation: Stop using this method if the react it gives negative results an er three treatments.

18. Transcutaneous Neurostimulator (TCNS/ Electro analgesic Nerve Block)
    

    Transcutaneous Neurostimulator (TCNS/ Electro analgesic Nerve Block) is not recommended.

19. Transcutaneous Electrical Nerve Stimulation (TENS)
    

    Treatment with Transcutaneous Electrical Nerve Stimulation (TENS) should involve at least one tutorial on how to use it correctly.

20. Transcutaneous Electrical Nerve Stimulation (TENS)
    

    Transcutaneous Electrical Nerve Stimulation (TENS) is recommended for specific usage as a second-line adjuvant to various first-line medicines in the treatment of persistent neck pain or chronic radicular pain syndrome.

    Indications: Include the management of concurrent pain, atrophy, and muscular spasm in the workplace. Before the deployment of a home unit, consistent, demonstrable functional progress must be demonstrated, and the possibility of chronicity must be assessed.

    Active physical therapy should be combined with TENS therapy.

    Maximum Duration: three meetings Invest in or include a home unit if useful.

    Ultrasound (Including Phonophoresis)

    Sonic generators are used in ultrasound therapy (including phonophoresis) to supply utilizing sound wave energy for the curative thermal and non-thermal pulpy and soft tissue effects.

21. Ultrasound (Including Phonophoresis)
    

    Ultrasound (Including Phonophoresis) is recommended clinically appropriate in a subset of individuals.

    Indications – include the need to stretch muscle tissue or hasten the healing of soft tissues, as well as scar tissue, adherence, collagen fiber, and muscular spasm. Electrical stimulation and ultrasound are electrical energy delivery methods that use dispersed electrode implantation simultaneously. Muscular spasms, scar tissue, pain reduction, and muscle facilitation are all indications.

    Phonophoresis is the process of administering medicine to the target area while using sonic generators to reduce pain and inflammation.

    Among these top-of-the-line drugs are anesthetics and steroidal anti-inflammatories, but they are not the only ones.

    Frequency: Typically, three times each week with an utmost of two months as clinically necessary. Six to fifteen sessions are required to achieve an impact.

    Optimum Duration: One to two months/ Four to eight weeks

What our office can do if you have a workers compensation injury

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

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