Purpose of study: For persons who experience chronic back and spinal injuries with related pain symptoms, spinal fusion surgery is commonly perceived to be a treatment of last resort. Post–lumbar spinal fusion patients are typically at the light physical demand level (20 pounds occasionally) or below upon completion of a traditional physical therapy program. A discharge at the light physical demand level not only restricts future employability but can potentially create a scenario for reinjury. This study examines the efficacy of a sports performance–based work conditioning/hardening program (SPWC/H) on increasing the functional capabilities of workers compensation subjects after lumbar fusion.Methods used: From 199 to 2001 a total of 45 male subjects, after lumbar fusion, 20 to 54 years of age (average, 36.5 years), with compensable injuries were enrolled in SPWC/H. Subjects were discharged from traditional physical therapy programs before entering the program. Three subjects did not complete SPWC/H because of nonmedical reasons. No injuries occurred during the program. Subjects completed 4 to 5 sessions per week and attended a minimum of 16 sessions (average, 32 sessions). Sessions focused on aerobic conditioning, flexibility, core stabilization, intense functional strength training with free weights and functional tasks. The daily training volumes (sets × repetition × load) was progressed using sports performance principles from an average of 10,921 pounds per day to 36,540 pounds per day. Before and after floor-to-waist and waist-to-overhead lifts were recorded. Final lifting results were compared with the physical demand levels as identified by the US Department of Labor.of findings: Floor-to-waist lifts averaged 24.8 pounds for 12.7 repetitions before SPWC/H. After SPWC/H, floor-to-waist lifts averaged 89.5 pounds for 12.2 repetitions. Waist-to-overhead lifts averaged 26.2 pounds for 13.1 repetitions before SPWC/H. After SPWC/H, waist-to-overhead lifts averaged 68.7 pounds for 12.1 repetitions. Predicted maximum values for both the before and after testing were obtained by using a standard formula accepted by the National Strength and Conditioning Association. T test comparisons of converted before and after testing were significant at the p<.001 level.Relationship between findings and existing knowledge: Few studies have documented physical demand level outcomes of workers compensation subjects after spinal fusion surgery. It has been suggested that this is because of the complexity of the procedure, the workmans compensation system, and/or poor rehabilitation. Forty-five percent of these participants completed SPWC/H at the heavy physical demand level (100 pounds occasionally) or above based on weights achieved. Ninety-seven percent of the participants completed SPWC/H at the medium physical demand level (50 pounds occasionally) or above.Overall significance of findings: After completion of SPWC/H, post–lumbar fusion subjects made significant strength gains contributing to improved functional physical ability. Increasing physical ability is important for future employability and decreasing risk of reinjury upon re-entering the workforce. Although a lumbar spinal fusion is often perceived as a treatment of last resort, it is clear that individuals who have undergone this procedure can significantly increase their strength and abilities to meaningful levels. This study suggests that SPWC/H is effective in increasing the physical demand level of post–lumbar fusion subjects to significant and meaningful levels upon completion of traditional physical therapy.Disclosures: No disclosures.Conflict of interest: No conflicts.