Understanding the Process and Challenges for Return-to-Work Post-Hematopoietic Cell Transplantation from a Musculoskeletal Perspective: A Narrative Review.
Jaleel Mohammed, Anne Gonzales, Hadeel R Bakhsh and 4 others
PMID 34316293WHAT IT FOUND
Using a musculoskeletal return-to-work model for post-HCT patients is expert consensus, not tested evidence.
Functional capacity evaluation and job evaluation can guide individualized plans, with monitoring for unpredictable complications.
Key findings
01The paper proposes applying a musculoskeletal return-to-work model to post-HCT patients, but presents it as expert consensus rather than tested evidence.
02Functional capacity evaluation and job evaluation are described as central steps for matching a patient's abilities to job demands, although functional capacity evaluation is not a gold standard for predicting return to work.
03Return-to-work after HCT is described as dynamic and unpredictable, with monitoring recommended for 12 to 18 months because graft-versus-host disease complications can develop up to 2 years after transplant.
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 recommendations are adapted from an existing musculoskeletal return-to-work model and expert consensus, not from HCT-specific prospective studies or randomized trials. The paper is a narrative review, so it does not provide tested evidence that the proposed model improves return to work after HCT. The search included allogenic transplant patients above 16 years old and excluded autologous transplant and neurological conditions, so the model may not apply to all HCT patients. Functional capacity evaluation is not a gold standard for predicting return to work. Interventions such as psychoeducational and physical interventions were not conducted on HCT patients, so their benefit for this population is unconfirmed. The paper does not address psychological impact, quality-of-life complications such as fatigue, depression and sleep disturbances, or immunocompromised patients with graft-versus-host disease of internal organs.
The easy way to misread this
Do not read the recommended functional capacity evaluation and job evaluation as proven to predict or improve return to work after HCT. The paper is a narrative review based on expert consensus, and it states that interventions from other populations have not confirmed benefit in HCT.