Presentation T P38

T P38 (Poster Presentation):
Systematic review on prognostic factors for return to work following carpal tunnel release

Presented by: Susan E Peters

Authors

Peters SE1,2, Coppieters MW1,3, Hines S4, Ross M2,5,6, Johnston V1

  1. School of Health and Rehabilitation Science, The University of Queensland, Brisbane, Australia
  2. Brisbane Hand and Upper Limb Research Institute, Brisbane, Australia
  3. VU University, Amsterdam, Netherlands
  4. Mater Medical Research Institute, Brisbane, Australia
  5. School of Medicine, The University of Queensland, Brisbane, Australia
  6. Department of Orthopaedics, Princess Alexandra Hospital, Brisbane, Australia

Abstract

Background

Workers undergoing carpal tunnel release (CTR) require time off work to recover from the surgery itself, and often to be rehabilitated back to work. The total time to return-to-work (RTW) following CTR can be highly variable. Differences in timeframes and outcomes are thought to be influenced by a number of modifiable and non-modifiable prognostic factors. The objective of this systematic review was to synthesise the best available evidence on prognostic factors for RTW in patients who have undergone CTR.

Methods

We followed the methodology of the Johanna Briggs Institute for prognostic studies. A protocol was developed and followed (1). Studies were assessed by two independent reviewers for methodological quality using a validated tool for systematic reviews of prognostic studies and relevant data were extracted for results from multivariate analysis. Narrative synthesis was performed on all included studies. A meta-analysis was unable to be performed due to heterogeneity of the included studies.

Results

13 studies were included. Few studies had low risk of bias for prognosis studies. Factors found to be prognostic for a work outcome post operatively were pre-surgery symptoms and function, family support, work-related social support, musculoskeletal pain sites, physical health, job control, work exposures, education level, gender, workers compensation, occupation classification, associated surgeries, legal involvement, pre-surgery work absence, days waiting for surgery, pre-surgery nerve conduction, mental health, lower income, job accommodation, recovery expectations.

Conclusions

Numerous factors have an association with RTW outcomes following CTR. Surprisingly, despite the plethora of studies, many variables found to be prognostic for RTW in other diagnostic groups (such as low back pain) have not yet been studied for CTR or were found to not be prognostic. However, caution needs to be taken when interpreting results from studies with low methodological quality and that have been conducted in different jurisdictions. More research needs to be conducted in the field of prognosis for RTW for upper extremity conditions. 1) Peters S, Johnston V, Hines S, Ross M, Coppieters M. (2011) Prognostic factors for return to work following Carpal Tunnel Release: A Systematic Review (Protocol). The Johanna Briggs Institute Library of Systematic Reviews. http://connect.jbiconnectplus.org/ViewSourceFile.aspx?0=5931.

Schedule Details

Tuesday September 30
12:45 - 13:45 Poster Viewing
Session: Work capacity / ability