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Bousfield K, Cheon JY, Harley S, Lampiris-Tremba A, Loseby J, Bianchi N, Barnes A, Escorpizo R. What are the Predictors of Return to Work for People With Elbow, Wrist, and Hand Conditions? A Systematic Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:380-413. [PMID: 34309763 DOI: 10.1007/s10926-021-09997-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
Purpose Conditions affecting the elbow, forearm, wrist, and hand can cause debilitating pain and loss of function in the working population. While there is knowledge about intervention options for this region of the body, there is limited research on systematically identifying the predictors of return to work in this population. Methods A systematic literature review identified all English-language studies that assess predictors of return to work for people with elbow, wrist, and hand conditions from 2009 to 2021 using PRISMA guidelines. Studies that examined exclusively shoulder injuries, randomized control trials, non-human studies, case studies, case reports, case series, and narrative reviews were excluded. Participants of included studies must have a health-related condition of the fingers, wrist, forearm, and elbow that is preventing work participation and must be 16 years and older. Included studies must be observational, longitudinal, and include a return to work outcome. Results Nineteen out of 170 studies were included. Average time away from work varied between seven to 304 days. Positive predictors of early return to work include: demographics, type of injury, type of treatment, work status, physical factors, psychological factors, use of self-reported outcome measures, and self-reported pain. Conclusion Five clinician recommendations were developed based on the findings of our systematic review. Clinicians should consider the type of work, use of outcome measures, psychological factors, hospitalization, and salary. These recommendations are intended to influence the behavior of clinicians when determining prognosis for return to work of people with elbow, wrist, and hand conditions.
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Affiliation(s)
- Kayla Bousfield
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, The University of Vermont, 106 Carrigan Drive, Burlington, VT, 05452, USA
| | - Ju-Young Cheon
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, The University of Vermont, 106 Carrigan Drive, Burlington, VT, 05452, USA
| | - Sarah Harley
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, The University of Vermont, 106 Carrigan Drive, Burlington, VT, 05452, USA
| | - Amber Lampiris-Tremba
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, The University of Vermont, 106 Carrigan Drive, Burlington, VT, 05452, USA
| | - Justin Loseby
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, The University of Vermont, 106 Carrigan Drive, Burlington, VT, 05452, USA
| | - Nancy Bianchi
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, The University of Vermont, 106 Carrigan Drive, Burlington, VT, 05452, USA
| | - Andrew Barnes
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, The University of Vermont, 106 Carrigan Drive, Burlington, VT, 05452, USA
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, The University of Vermont, 106 Carrigan Drive, Burlington, VT, 05452, USA.
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Buchanan H, Van Niekerk L, Grimmer K. Work transition after hand injury: A scoping review. J Hand Ther 2022; 35:11-23. [PMID: 33250399 DOI: 10.1016/j.jht.2020.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/20/2020] [Accepted: 10/09/2020] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic scoping review. INTRODUCTION Many factors are potentially associated with successful work-related transitions following hand injury. There is no current, comprehensive review of the literature to guide clinical practice. PURPOSE OF THE STUDY To comprehensively identify the current body of research evidence supporting return to work (RTW) after hand injury and identify gaps. METHODS A systematic search identified relevant, peer-reviewed, full text, English language primary qualitative or quantitative literature published since 2006. All authors independently determined whether studies should be included, assigned them to a hierarchy of evidence and extracted data. Decisions were defended and disagreements resolved in team meetings. Literature was summarized into key themes using common intent and constructs. RESULTS Of 259 potentially-relevant articles, 38 were relevant. Study designs included prospective observational, cross-sectional, and retrospective (n=9 each), mixed methods (n=3), qualitative (n=4), and opinion pieces (n=4). There were no experimental studies. The most commonly-reported key themes were prognostic factors for RTW (25 papers) and assessment tools (18 papers). Remaining themes of impact of injury on the individual, patient perspectives, other stakeholder perspectives, healthcare provider education, and treatment were reported in fewer than 10 papers each. There was little commonality in how research was conducted or reported. Gaps included lack of information on effective interventions, which prognostic factors should be routinely measured, and which assessment and outcome items to routinely use in practice. CONCLUSION Despite the impact of hand injury on capacity to RTW, there is limited evidence to inform successful work-related transitions.
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Affiliation(s)
- Helen Buchanan
- Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Lana Van Niekerk
- Division of Occupational Therapy, Department of Health and Rehabilitation Science, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Karen Grimmer
- Division of Physiotherapy, Department of Health and Rehabilitation Science, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
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Clinical Guidance to Optimize Work Participation After Injury or Illness: The Role of Physical Therapists. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG102. [PMID: 34338006 DOI: 10.2519/jospt.2021.0303] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Work rehabilitation refers to the process of assisting workers to remain at work or return to work (RTW) in a safe and productive manner, while limiting the negative impact of restricted work, unemployment, and work disability. The primary purpose of this clinical practice guideline (CPG) is to systematically review available scientific evidence and provide a set of evidence-based recommendations for effective physical therapy evaluation, treatment, and management of individuals experiencing limitations in the ability to participate in work following injury or illness. J Orthop Sports Phys Ther 2021;51(8):CPG1-CPG102. doi:10.2519/jospt.2021.0303.
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Gutman MJ, Patel MS, Katakam A, Liss N, Zmistowski BM, Lazarus MD, Horneff JG. Understanding Outcomes and the Ability to Return to Work After Rotator Cuff Repair in the Workers' Compensation Population. Cureus 2021; 13:e14213. [PMID: 33948403 PMCID: PMC8086523 DOI: 10.7759/cureus.14213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Patients with a worker compensation claim are associated with a greater probability of continued symptoms and activity intolerance. This study aims to determine predictors of improved patient-reported outcomes in the workers’ compensation population. Methods Patients with workers’ compensation claims undergoing arthroscopic rotator cuff repair between 2010 and 2015 were included. Age, gender, dominant hand, occupation, and number of tendons involved were analyzed. At a minimum of two years, patients were contacted to complete American Shoulder and Elbow Surgeons (ASES) Survey, Simple Shoulder Test (SST), and return-to-work status (RTW). Preoperative characteristics and scores were then compared. Results Seventy patients were available for follow-up at an average of 5.4 years (range: 2.1-8.8 years). Average age was 55 years (range: 37-72); 55 (78.6%) were males, 23 (32.9%) were laborers; and 59 (84.2%) patients returned to work. The sole predictor for RTW was surgery on the non-dominant arm (96.5% versus 75.6%; p = 0.021). Laborers showed decreased RTW (p = 0.03). Patients who completed RTW had excellent outcomes with higher ASES (87 versus 50; p value < 0.001) and SST scores (10.4 versus 4.6; p < 0.001). Patients with three tendon tears had inferior ASES (p = 0.026) and SST (p = 0.023) scores than those with less. Conclusion Most workers’ compensation patients have excellent outcomes from rotator cuff repair. Patients with three tendon tear repairs demonstrated the worst functional outcomes. Laborers showed decreased ability to RTW with nearly one-third unable.
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Affiliation(s)
- Michael J Gutman
- Shoulder and Elbow Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, USA
| | - Manan S Patel
- Shoulder and Elbow Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, USA
| | - Akhil Katakam
- Shoulder and Elbow Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, USA
| | - Nathan Liss
- Shoulder and Elbow Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, USA
| | | | - Mark D Lazarus
- Shoulder and Elbow Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, USA
| | - John G Horneff
- Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, USA
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Izadi N, Jamshidi S, Mehrdad R, Nasibi E. Predictors of return to work in patients with occupational hand injury. HAND SURGERY & REHABILITATION 2020; 39:218-222. [PMID: 32112867 DOI: 10.1016/j.hansur.2020.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 01/19/2023]
Abstract
Work-related hand injuries are the primary cause of disability and prolonged time away from work. This prospective cohort study was conducted to determine the predictors of return to work (RTW) after traumatic work-related hand injuries. Our study included 280 patients who were referred to the Plastic and Reconstructive Center for treatment of their occupational hand injuries from July 2017 to February 2018. Several functional questionnaires were completed, and they were followed up at 1, 3 and 8 weeks. Telephone interviews were done 3 months later. Approximately half the subjects had returned to work during the first 3 months after a median time away of 57 days. No relationship was found between age, gender, marital status, hand dominance and RTW time. Nevertheless, there was correlation between RTW time with cigarette smoking, injury severity and disability. Our study findings suggest that injury severity and higher work disability scores are prognostic factors for RTW. Also, smoking was associated with later RTW, which could be the result of poor circulation and delayed healing. Employers should implement injury prevention programs with appropriate rehabilitation that takes into consideration the severity of the hand injury, and health strategies to improve unhealthy lifestyle factors such as smoking.
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Affiliation(s)
- N Izadi
- Center for Research on Occupational Disease, Tehran University of Medical Sciences, No. 226, Qods Street, Keshavarz Boulevard, 1416753955 Tehran, Iran.
| | - S Jamshidi
- Plastic and reconstructive surgery, Iran University of Medical Sciences, Tehran Hemat Highway next to Milad Tower 14496, 14535 Tehran, Iran.
| | - R Mehrdad
- Center for Research on Occupational Disease, Tehran University of Medical Sciences, No. 226, Qods Street, Keshavarz Boulevard, 1416753955 Tehran, Iran.
| | - E Nasibi
- Center for Research on Occupational Disease, Tehran University of Medical Sciences, No. 226, Qods Street, Keshavarz Boulevard, 1416753955 Tehran, Iran.
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Champagne R, Bodin J, Fouquet N, Roquelaure Y, Petit A. Functional incapacity related to rotator cuff syndrome in workers. Is it influenced by social characteristics and medical management? J Hand Ther 2020; 32:322-327. [PMID: 29217292 DOI: 10.1016/j.jht.2017.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 10/09/2017] [Accepted: 10/12/2017] [Indexed: 02/09/2023]
Abstract
STUDY DESIGN Survey. INTRODUCTION Rotator cuff syndrome (RCS) is one of the most common musculoskeletal disorders reported in workers. The functional incapacity related to RCS may vary according to the sociodemographic context and to the medical management. PURPOSE OF THE STUDY The purpose of this is to analyze the RCS-related functional incapacity assessed by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires in workers according to their sociodemographic characteristics and the use of care. METHODS A cross-sectional study was carried out on a French sample of workers diagnosed with RCS. The DASH and DASH-work scores were studied according to the sociodemographic factors, musculoskeletal symptoms, and RCS medical management during the preceding 12 months. RESULTS Two hundred seven workers who suffered from RCS filled out the questionnaire of which 80% were still working. The DASH score was significantly higher in women (24.0 vs 17.4; P < .01; effect size (d) = 0.39), in patients over the age of 50 years (23.6 vs 11.3; P < .005) and in case of another upper limb musculoskeletal disorder (P < .0001; d ≥ 0.4). The DASH and DASH-work scores were significantly higher in case of use of care for RCS (P < .005; d > 0.6). DISCUSSION The demographic factors and the RCS medical management influenced the overall incapacity assessed by the DASH questionnaire. Work incapacity was more especially related to the use of care for RCS. CONCLUSION The sociodemographic and medical parameters added to other established predictors could help guide clinicians in managing their patients.
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Affiliation(s)
- Romain Champagne
- INSERM, U1085, IRSET, ESTER Team, University of Angers, Angers, France
| | - Julie Bodin
- INSERM, U1085, IRSET, ESTER Team, University of Angers, Angers, France
| | - Natacha Fouquet
- INSERM, U1085, IRSET, ESTER Team, University of Angers, Angers, France; Santé publique France, French National Public Health Agency, Direction of Occupational Health, Saint Maurice, France
| | - Yves Roquelaure
- INSERM, U1085, IRSET, ESTER Team, University of Angers, Angers, France; Department of Occupational health, University Hospital of Angers, Angers, France
| | - Audrey Petit
- INSERM, U1085, IRSET, ESTER Team, University of Angers, Angers, France; Department of Occupational health, University Hospital of Angers, Angers, France.
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Factors associated with return to work among survivors of out-of-hospital cardiac arrest. Resuscitation 2020; 146:203-212. [DOI: 10.1016/j.resuscitation.2019.09.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/21/2019] [Accepted: 09/08/2019] [Indexed: 11/18/2022]
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Jacobs NW, Berduszek RJ, Dijkstra PU, van der Sluis CK. Validity and Reliability of the Upper Extremity Work Demands Scale. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:520-529. [PMID: 27848067 PMCID: PMC5709455 DOI: 10.1007/s10926-016-9683-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Purpose To evaluate validity and reliability of the upper extremity work demands (UEWD) scale. Methods Participants from different levels of physical work demands, based on the Dictionary of Occupational Titles categories, were included. A historical database of 74 workers was added for factor analysis. Criterion validity was evaluated by comparing observed and self-reported UEWD scores. To assess structural validity, a factor analysis was executed. For reliability, the difference between two self-reported UEWD scores, the smallest detectable change (SDC), test–retest reliability and internal consistency were determined. Results Fifty-four participants were observed at work and 51 of them filled in the UEWD twice with a mean interval of 16.6 days (SD 3.3, range = 10–25 days). Criterion validity of the UEWD scale was moderate (r = .44, p = .001). Factor analysis revealed that ‘force and posture’ and ‘repetition’ subscales could be distinguished with Cronbach’s alpha of .79 and .84, respectively. Reliability was good; there was no significant difference between repeated measurements. An SDC of 5.0 was found. Test–retest reliability was good (intraclass correlation coefficient for agreement = .84) and all item-total correlations were >.30. There were two pairs of highly related items. Conclusion Reliability of the UEWD scale was good, but criterion validity was moderate. Based on current results, a modified UEWD scale (2 items removed, 1 item reworded, divided into 2 subscales) was proposed. Since observation appeared to be an inappropriate gold standard, we advise to investigate other types of validity, such as construct validity, in further research.
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Affiliation(s)
- Nora W. Jacobs
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Redmar J. Berduszek
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Pieter U. Dijkstra
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Corry K. van der Sluis
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Armijo-Olivo S, Woodhouse LJ, Steenstra IA, Gross DP. Predictive value of the DASH tool for predicting return to work of injured workers with musculoskeletal disorders of the upper extremity. Occup Environ Med 2016; 73:807-815. [PMID: 27558703 DOI: 10.1136/oemed-2016-103791] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/27/2016] [Accepted: 08/09/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine whether the Disabilities of the Arm, Shoulder, and Hand (DASH) tool added to the predictive ability of established prognostic factors, including patient demographic and clinical outcomes, to predict return to work (RTW) in injured workers with musculoskeletal (MSK) disorders of the upper extremity. METHODS A retrospective cohort study using a population-based database from the Workers' Compensation Board of Alberta (WCB-Alberta) that focused on claimants with upper extremity injuries was used. Besides the DASH, potential predictors included demographic, occupational, clinical and health usage variables. Outcome was receipt of compensation benefits after 3 months. To identify RTW predictors, a purposeful logistic modelling strategy was used. A series of receiver operating curve analyses were performed to determine which model provided the best discriminative ability. RESULTS The sample included 3036 claimants with upper extremity injuries. The final model for predicting RTW included the total DASH score in addition to other established predictors. The area under the curve for this model was 0.77, which is interpreted as fair discrimination. This model was statistically significantly different than the model of established predictors alone (p<0.001). When comparing the DASH total score versus DASH item 23, a non-significant difference was obtained between the models (p=0.34). CONCLUSIONS The DASH tool together with other established predictors significantly helped predict RTW after 3 months in participants with upper extremity MSK disorders. An appealing result for clinicians and busy researchers is that DASH item 23 has equal predictive ability to the total DASH score.
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Affiliation(s)
- Susan Armijo-Olivo
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Linda J Woodhouse
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Ivan A Steenstra
- Ted Rogers School of Management, Ryerson University, Toronto, Ontario, Canada
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
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