Determinants of work absence following surgery for carpal tunnel syndrome

Katz, Jeffrey N.; Amick, Benjamin C.; Keller, Robert B.; Fossel, Anne H.; Ossman, Janet; Soucie, Valerie; Losina, Elena

doi:10.1002/ajim.20127

Cited by 98 publications

(118 citation statements)

References 33 publications

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“…One can also infer the greater savings in pain and workplace absence. 10,13 The limitations of this study include that only a small population was tested and that this trial was conducted at only one site. Another limitation is that the experimental treatment duration was limited to 60 days.…”

Section: Discussionmentioning

confidence: 99%

“…The differential diagnosis assessment includes patient history, physical examination, and electrodiagnostic testing (motor and sensory nerve conduction). 2,6,[9][10][11][12][13][14][15][16][17][18][19][25][26][27][28][29] Current treatments for CTS still often require postoperative sick leave that exceeds 2 weeks, 10,13,21,24,26 and Dynasplint splinting uses a prolonged duration of passive, joint-specific, end-range (of motion) stretching with low loads of force. Dynamic splinting has been shown to reduce sick-leave time.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal Outcomes Following a Randomized Controlled Trial of Dynamic Splint Stretching for Carpal Tunnel Syndrome

Willis

Fowler

2016

Hand (New York, N,Y.)

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Background: The incidence of carpal tunnel syndrome (CTS) is 48 million patients in the United States. The purpose of this longitudinal study was to determine whether Dynasplint stretching (immediately after diagnosis) had an effect on a patient's decision to seek surgical treatment for CTS. Methods: Fifty patients (10 men, 40 women, mean age 51.2 ± 12 years) were recruited for this randomized, controlled, longitudinal trial. Patients were diagnosed with CTS by physical examination and nerve conduction studies. The intervention used was Dynasplint stretching that delivered a prolonged duration of low load stretching. Patients who were randomly chosen for the Experimental category wore the device for two 30-minute sessions per day with regular increases in splint tension for 60 days. Control patients received nonsteroidal anti-inflammatory medication plus instructions on daily home stretching. Results: The final, longitudinal outcome showed a 72% reduction in surgery chosen by the experimental group (n = 25), compared with 38% reduction for control patients (n = 25). Conclusions: Immediate treatment with Dynasplint stretching showed a 2 to 1 reduction in surgery, with abundant financial savings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Longitudinal Outcomes Following a Randomized Controlled Trial of Dynamic Splint Stretching for Carpal Tunnel Syndrome

Willis

Fowler

2016

Hand (New York, N,Y.)

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“…Volinn et al 24 (1991) examined benefi ts granted due to low-back pain in the United States and found an inverse relation between income and duration of the work leave. Katz et al 13 analyzed factors related to return to work among workers who underwent surgery for carpal tunnel syndrome and observed that individuals with lower income had odds almost four times higher of remaining on leave compared to those with higher income. A literature review showed a strong and consistent inverse association between social class and duration of work leave due to low-back pain, mainly among men.…”

Section: Discussionmentioning

confidence: 99%

“…Expectation of returning to work among patients submitted to surgery due to carpal tunnel syndrome was the most important predictor of absence from work. 13 The reason that infl uences workers' expectation is not exactly known, nor the mechanisms of its association with duration of work leave. A qualitative study with workers with occupational low-back pain showed that the expectation of returning to work refl ects four domains: fi nancial and job security, possibility of recurrence of the health problem, social support at the workplace and self-image.…”

Section: Discussionmentioning

confidence: 99%

Fatores associados à duração dos benefícios por incapacidade: um estudo de coorte

Souza

Santana²

2012

Rev. Saúde Pública

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OBJECTIVE:To analyze factors associated with the duration of disability benefi ts due to work-related upper-limb musculoskeletal disorders. METHODS:Ambispective cohort study conducted with 563 insured workers from the General Social Security System who received temporary disability benefi ts due to work-related upper-limb musculoskeletal disorders in the city of Salvador, Northeastern Brazil, in 2008. The data came from an inquiry performed by the Regional Audit of the National Social Security Institute and from administrative records. Sociodemographic and work-related variables were analyzed, as well as characteristics of the health problem and aspects related to social security. Factors associated with time until the cessation of the benefi t were identifi ed through survival analysis techniques. RESULTS:Low socioeconomic position (RR=1.29; 95%CI 1.02; 1.64), age below 39 years (RR=1.23;95%CI 1.03; 1.47), income replacement by the National Social Security Institute ≤ 100% (RR=1.24; 95%CI 1.04; 1.47) and high expectation of returning to work (RR=1.20; 95%CI 1.00; 1.44) are the categories related to higher rate of cessation of the benefi t and with its shorter duration. CONCLUSIONS:Factors that are not strictly medical, like socioeconomic position, age, expectation of returning to work and level of income replacement by the National Social Security Institute, seem to infl uence the benefi t's duration. These hypotheses need to be tested with further confi rmatory studies in order to improve the understanding of the process of determining incapacity for work.

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“…In choosing a single hand condition to study, carpal tunnel syndrome is ideal because its prevalence, clinical presentation and postoperative outcome are well established (7).…”

mentioning

confidence: 99%

Analysis of reporting return to work in studies comparing open with endoscopic carpal tunnel release: A review of randomized controlled trials

Ayeni¹,

Thoma²

2005

CAN J PLAST SURG

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BACKGROUND:In studies comparing open with endoscopic carpal tunnel release, return to work (RTW) is often cited as a primary outcome. OBJECTIVE: The present study assessed the reporting of RTW and evaluated its usefulness in studies comparing these two methods of carpal tunnel release. METHODS: A computerized search was conducted to find randomized controlled trials that compared open with endoscopic carpal tunnel release, with RTW as an outcome measure. The factors that were compared across the studies included definition of RTW, units quantifying RTW, measures of hand function, patients' type of employment, worker's compensation or insurance status, patients' handedness, unilateral or bilateral carpal tunnel release, and use of rehabilitation. RESULTS: Fifteen studies met the inclusion criteria for the present systematic review. Of the 15 studies reviewed, there were seven definitions of RTW. All studies defined whether the patients underwent unilateral or bilateral carpal tunnel release but there was variability in the calculation of RTW when bilateral releases were performed. The impact of worker's compensation or insurance, type of work, handedness and rehabilitation were inconsistently addressed as factors affecting RTW. CONCLUSIONS: Although RTW ideally reflects function and recovery, it is inadequately measured and reported. The present review revealed that, in studies comparing open carpal tunnel release with endoscopic carpal tunnel release, there is lack of uniformity in reporting RTW, which may contribute to the inconclusive results for RTW. Future research needs to ensure that RTW is used in a consistent manner.

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Determinants of work absence following surgery for carpal tunnel syndrome

Abstract: Clinical, demographic, economic, and workplace factors were associated with work absence. Strategies to reduce work absence following carpal tunnel release should address multiple dimensions of the worker and workplace.

Cited by 98 publications

References 33 publications

Longitudinal Outcomes Following a Randomized Controlled Trial of Dynamic Splint Stretching for Carpal Tunnel Syndrome

Longitudinal Outcomes Following a Randomized Controlled Trial of Dynamic Splint Stretching for Carpal Tunnel Syndrome

Fatores associados à duração dos benefícios por incapacidade: um estudo de coorte

Analysis of reporting return to work in studies comparing open with endoscopic carpal tunnel release: A review of randomized controlled trials

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