Prognostic factors for return to work following Carpal Tunnel Release: Systematic Review.

Abstract

Review objective The objective of the systematic review is to synthesise the best available evidence on the effect of early prognostic factors on return to work outcomes in patients who have undergone carpal tunnel release surgery. Inclusion criteria Types of participants This review will consider articles for inclusion according to the following criteria: Studies included patients/participants that have undergone a primary carpal tunnel release and are returning to work; Patients/participants included those employed for a wage at the time of the surgery; Studies included those investigating at least one prognostic factor; and, Study design was longitudinal and the paper reported results with statistical analysis appropriate to prognostic studies. There will be no restrictions on age, gender, type of work, or type of carpal tunnel surgery i.e. open, minimally invasive, single or double portal endoscopic surgery. Phenomena of interest The focus of interest for this systematic review is the association between a number of prognostic factors, and return to work outcomes. Types of Prognostic Factors This review will consider prognostic factors in the following domains: Demographic factors, e.g. age, education, hand-dominance; Worker clinical factors e.g. pre-operative physical status, smoker, diabetes, obesity, pre-operative pain reporting, baseline symptom severity and duration of symptoms; Psychosocial factors e.g. depression, self-efficacy; Economic considerations: workers compensation status, income; Workplace physical demands ; Workplace psychosocial demands; e.g. psychological work demands, supervisor support, and job control; and, Organisational factors e.g. legislative process. Surgical factors e.g. bilateral surgery, type of release Types of Outcomes This review will consider studies that examine the association between prognostic factors and the following outcome measures: return to work timeframe or length of absence from work; return to work capacity outcomes, that is the time workers returned to work in a defined capacity: o return to normal duties o return to reduced capacity duties o return to alternate duties or host employment o did not return to work