Systematic Review of Biopsychosocial Prognostic Factors for Return to Work After Acute Orthopedic Trauma: A 2020 Update.
Hong Phuoc Duong, Anne Garcia, Roger Hilfiker and 2 others
PMID 36188871WHAT IT FOUND
Injury severity was the clearest early factor and a late barrier to return to work after acute orthopedic trauma.
In the late phase, older age, high pain, low self-efficacy, lower education, blue-collar work, and compensation status were linked to delayed return.
Key findings
01Injury severity was the only early biological factor supported by strong evidence.
02In the late phase, age, injury severity, pain, self-efficacy, education, blue-collar work, and compensation status had strong evidence.
03Recovery expectations and physical workload had moderate evidence, while gender was inconsistent.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The included studies were observational prognostic-factor studies, so they show associations, not proof that changing a factor improves return to work. Of 30 studies, 7 had low risk of bias, 21 had moderate risk, and 2 had high risk. Loss to follow-up was reported in 25 studies and ranged from 1 to 53%. Return-to-work definitions varied widely, so the reviewers could not combine the results into a meta-analysis. The review excluded brain injury, medullar injury, whiplash, repeated trauma, and samples smaller than 80, so findings do not cover those groups. Compensation findings depend on country systems; compensation was not related to return to work in Taiwan. Most studies were at the development stage and did not validate prediction models in new patients.
Declared interests
The authors declared no commercial or financial relationships that could be a conflict of interest.
The easy way to misread this
Do not read these factors as proof that treating pain or boosting self-efficacy will speed return to work. The studies were observational and mostly reported associations, not tested interventions.