Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Return to Work”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,423 records · Page 79Linked to original sources
PubMed1995

Early mobilization following carpal tunnel release. A prospective randomized study.

A prospective randomized study was undertaken of 50 consecutive patients undergoing surgery for idiopathic carpal tunnel syndrome to determine the value of splintage of the wrist following open carpal tunnel release. Patients were randomized to either be splinted for 2 weeks following surgery or to begin range-of-motion exercises on the first post-operative day. Subjects were evaluated at 2 weeks, 1 month, 3 months, and 6 months after surgery by motor and sensory testing, physical examination, and a questionnaire. Variables assessed included date of return to activities of daily living, dates of return to work at light duty and at full duty, pain level, grip strength, key pinch strength, and occurrence of complications. Patients who were splinted had significant delays in return to activities of daily living, return to work at light and full duty, and in recovery of grip and key pinch strength. Patients with splinted wrists experienced increased pain and scar tenderness in the first month after surgery; otherwise there was no difference between the groups in the incidence of complications. We conclude that splinting the wrist following open release of the flexor retinaculum is largely detrimental, although it may have a role in preventing the rare but significant complications of bowstringing of the tendons or entrapment of the median nerve in scar tissue. We recommend a home physiotherapy programme in which the wrist and fingers are exercised separately to avoid simultaneous finger and wrist flexion, which is the position most prone to cause bowstringing.

Activities of Daily Living↗
PubMed2002

Bilateral endoscopic carpal tunnel releases: Simultaneous versus staged operative intervention.

PURPOSE: Open and endoscopic carpal tunnel release techniques have achieved excellent results for treatment of carpal tunnel syndrome. Symptoms frequently occur bilaterally but there are no reports of simultaneous operative intervention. The purpose of this study was to evaluate results in patients who underwent staged bilateral endoscopic carpal tunnel releases and in those who underwent simultaneous bilateral releases. TYPE OF STUDY: Retrospective review. METHODS: The efficacy of simultaneous and staged bilateral endoscopic carpal tunnel releases was evaluated using a retrospective chart review. This included patients who underwent these procedures during a 48-month period. Group A (48 patients) underwent staged procedures; group group B (48 patients) underwent simultaneous procedures. Inclusion criteria were a positive history and physical examination, positive electrical studies, and failure of conservative measures. Single-incision endoscopic releases were performed on an outpatient basis. Early rehabilitation with intermittent splinting was utilized. The analysis included complications, satisfaction, return to work, physician visits, physical therapy sessions, days to maximum medical improvement for all, and average percentage permanent partial impairment for Workers' Compensation patients. RESULTS: A decrease in return to work at regular duty was noted in the simultaneous group compared with the staged group for patients who had not filed Workers' Compensation claims (P =.0158). The simultaneous group had fewer physician visits than the staged group (P =.0002). Overall patient satisfaction was equal. CONCLUSIONS: Simultaneous bilateral endoscopic carpal tunnel releases are well tolerated with mild restrictions and a decrease in cost.

Absenteeism↗
PubMed1990

A multicenter analysis of percutaneous discectomy.

This study was performed to evaluate a group of patients undergoing percutaneous discectomy. All patients had a single level unilateral L4-5 or L5-S1 disc herniation documented on either computer tomographic (CT) scan, myelogram, and/or magnetic resonance imaging (MRI). Average follow-up after percutaneous discectomy was 16.8 months (range, 2-46 months). The average hospitalization time was 1.7 days (range, 1-5 days). Only 21 patients (55%) were able to return to work after the procedure. Thirteen patients ultimately underwent surgical discectomy for continued symptoms after the procedure. The additional 4 patients did not undergo surgical discectomy and never returned to work. Of those 25 percutaneous discectomy patients who did not undergo surgical discectomy, there was significantly more pain, residual weakness, and numbness compared with the patients undergoing surgical discectomy. The results of this study clearly indicate that percutaneous discectomy does not appear to be as predictable or successful a treatment modality as surgical discectomy.

Adult↗
PubMed2003

Comparison of Marie Stopes scalpel and electrocautery no-scalpel vasectomy techniques.

OBJECTIVE: To compare the intra-operative experience and postoperative sequelae between the standard Marie Stopes scalpel vasectomy procedure and electrocautery non-scalpel vasectomy (ENSV) techniques. DESIGN: Randomised prospective comparative study. SETTING: Marie Stopes vasectomy centres in the UK. PARTICIPANTS: A total of 325 men undergoing vasectomy between January and June 1999. INTERVENTION: Random allocation to the two study arms plus questionnaires at 4 and 14 weeks postoperatively. MAIN OUTCOME MEASURES: Ease and speed of the procedure; pain levels during and after the procedure; early postoperative complications and time taken to return to work and sexual activity. RESULTS: The ENSV technique was marginally quicker to perform. Pain levels intra-operatively were comparable. Response rates to the questionnaire were 84.6% and 37% at 4 and 14 weeks, respectively. The ENSV group experienced less pain and bleeding from the wound postoperatively and were quicker to heal. For men who experienced postoperative problems, the time taken to return to work was marginally better in the ENSV group. The time taken to return to sexual activity was marginally faster in the ENSV group. CONCLUSION: The ENSV procedure appears to be suitable for mass application in locations where electricity is available.

Adult↗
PubMed1999

Determinants of the breastfeeding pattern among working women in São Paulo.

The needs of breastfeeding women who work away from home differ from those of other women, particularly those who breastfeed exclusively. Sixty-nine factory workers were interviewed in São Paulo, both during pregnancy and when they returned to work. Median durations of exclusive (EBF), predominant (PBF), and any breastfeeding (BF) were found to be 10 days, 70 days, and 150 days, respectively. Despite having used the 4-month leave to which they were entitled, by 1 month, 86% of the respondents had given tea, 50% water, and 42% artificial baby milk. Only 2 women were still exclusively breastfeeding when they returned to work. Various personal characteristics were associated with longer duration of breastfeeding. Maternity ward routines were generally not supportive, but duration of PBF was longer where better support was received. Duration of EBF was longer among women with support for breastfeeding at work, and shorter for those working on weekends or doing shift work. Thus, women may have adjusted their feeding patterns based on whether or not they anticipated workplace support. Only weekend work and socioeconomic status were linked to shorter duration of breastfeeding. Stronger social and health care support for EBF may be needed before the full impact of workplace support can be usefully studied in Brazil.

Adult↗
PubMed1989

Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study.

The functional outcome of patients with lumbar herniated nucleus pulposus without significant stenosis was analyzed in a retrospective cohort study. Inclusion criteria were as follows: 1) a chief complaint of leg pain, primarily; 2) a positive straight leg raising (SLR) at less than 60 degrees reproducing the leg pain; 3) a computed tomography (CT) scan demonstrating a herniated nucleus pulposus without significant stenosis by a radiologist's reading, which was also confirmed by the authors; 4) a positive electromyogram (EMG) demonstrating evidence of radiculopathy; and 5) response to a follow-up questionnaire. All patients had undergone an aggressive physical rehabilitation program consisting of back school and stabilization exercise training. Of a total of 347 consecutively identified patients, 64 patients with an average follow-up time of 31.1 months met the inclusion criteria and constituted the study population. They were sent questionnaires that inquired about activity level, pain level, work status, and further medical care. The patients with neurologic loss, extruded discs, and those seeking a second opinion regarding surgery were identified and subgrouped. Results for the total group included 90% good or excellent outcome with a 92% return to work rate. For the subgroups with extruded discs and second opinions, 87% and 83% had good or excellent outcomes, respectively, all (100%) of whom returned to work. Sick leave time for these subgroups was 2.9 months (+/- 1.4 months) and 3.4 months (+/- 1.7 months), respectively. These results compared favorably with previously published surgical studies. Four of six patients who required surgery were found to have stenosis at operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1999

The association of the SF-36 health status survey with 1-year socioeconomic outcomes in a chronically disabled spinal disorder population.

STUDY DESIGN: The Short Form Health Survey (SF-36) was administered to patients with chronic spinal disorders both before and after tertiary rehabilitation. The association of the SF-36 with various socioeconomic outcomes was then examined. OBJECTIVES: To assess the correlation of scores on SF-36 with treatment program completion and clinically meaningful 1-year socioeconomic outcomes. SUMMARY OF BACKGROUND DATA: There has been much interest in identifying variables that can predict which disabled workers with chronic spinal disorders will have good versus poor socioeconomic outcomes after tertiary rehabilitation. Results of previous research have indicated that psychosocial factors are better predictors of such outcomes than physical factors. A more recent trend in research is assessing health-related quality of life from the health care recipient's perspective. METHODS: The SF-36 was administered to a cohort (n = 146) of patients chronically disabled by spinal disorders before entry into a tertiary functional restoration program. Of this cohort, preprogram SF-36 scores and 1-year socioeconomic data were available for 128 program completers and 18 program noncompleters. The pre- and postprogram SF-36 scores of program completers for each of the outcome variables were compared. RESULTS: Better scores on the preprogram SF-36 Social Functioning and Bodily Pain scales were found to be associated with successful completion of the treatment program. Postprogram SF-36 scores were more frequently associated with outcomes than were preprogram scores. Most SF-36 scores, especially the physical domain scales, were associated with the variables of return to work, work retention, and use of health care resources. The overwhelming majority of significant associations were between higher (i.e., better) SF-36 scores and "good" treatment outcomes (e.g., return-to-work). CONCLUSIONS: The large number of associations between SF-36 scores and outcome variables highlights the importance of assessing the health-related quality of life of patients, and supports the use of the SF-36 in accomplishing this task. Among the findings, perhaps the most significant was the value of assessing health-related quality of life, particularly the subjective physical components, after completion of a functional restoration program. Prediction of long-term socioeconomic outcomes is likely to be improved if assessment is conducted at the end of the treatment process. SF-36 is recommended for assessing general health status, and more spine-specific measures are recommended for assessing spinal pain and disability variables.

Adult↗
PubMed1994

Low back pain: program description and outcome in a case series.

Studies are needed to enhance our understanding of functional outcomes. The purpose of this paper is to describe a community clinic program for injured workers with low back pain and to report outcomes of the first 50 consecutive patients to enter the program who were evaluated using a standardized assessment procedure. Data for this report were collected from a retrospective chart review as part of an evaluation of the program. The patients referred to the clinic entered a 4-week treatment program. They were assessed at entry and discharge using the Toronto-Hamilton Lumbar Database. The database assessment is a standardized evaluation for documenting subjective and objective clinical data, and the protocol includes a diagnostic classification system and pain and function ratings. The results of this investigation include a statistically significant (p < 0.05) decrease in pain and increase in function as measured by the Jan van Breemen pain and disability scales and the Sickness Impact Profile. Seventy-four percent of the treatment group had returned to work by 6 weeks postdischarge from the program. This study suggests that a significant improvement in functional capabilities, a decrease in pain and disability indices, and higher return-to-work rates can be achieved through a 4-week, community-based multiprofessional rehabilitation program.

Adult↗
PubMed1998

[Medico-economic evaluation of treatment of inguinal hernia: Shouldice vs. laparoscopy].

Between May 1994 and September 1995, 64 men were included in a randomized prospective study comparing conventional Shouldice repair (S group) and transperitoneal laparoscopic repair with polypropylene mesh (L group). Cost evaluation was divided into distinct parts: drugs, non usable surgical materials, medico-technical procedures food and employees costs. In group S, mean operating time was 56', total cost was 3,922 FF in the case of unilateral hernia and 4,808 FF and respectively 77' in the case of bilateral hernia. In group L, mean operative time was 89', total cost 8,949 FF (disposable trocars) and 7,136 FF (non-disposable trocars) in the case of unilateral hernia and 116', 9,570 FF and 7,763 FF in case of bilateral hernia. Postoperative stay was 4.2 days in group S and 4 days in group L. Return to work was 28.6 days in group L and 35.5 days in group S (ns). In conclusion laparoscopic hernia repair does not decrease post operative pain, hospital stay and return to work, but is twice as expensive.

Adult↗
PubMedDate not supplied

Quality of life in patients surviving at least 12 months following high dose chemotherapy with autologous bone marrow support.

BACKGROUND: Over the past decade, high dose chemotherapy with autologous bone marrow (HDC-ABMT) support has been used increasingly in the treatment of patients with breast cancer. In evaluating the results of HDC-ABMT in patients with breast cancer, an assessment of quality of life can add to the traditional endpoints (toxicity, and disease-free and overall survival) that are routinely assessed in clinical trials. PURPOSE: This study evaluated the quality of life (QOL) of breast cancer patients who had survived 1 or more years following high dose chemotherapy with autologous bone marrow transplant (HDC-ABMT) support. METHODS: Eighty-two patients who had undergone HDC-ABMT were surveyed by written questionnaire and follow-up telephone interview at least 1 year following HDC-ABMT. Patients were asked to complete the Functional Living Index-Cancer (FLIC), the Symptom Distress Scale (SDS), and a survey of sexual function developed as part of the study. RESULTS: The mean FLIC score among all patients was 130 +/- 19.1 (possible range 22-154). FLIC scores were significantly lower in patients with evidence of recurrent disease than in patients who were free of disease. The most commonly reported symptoms after HDC-ABMT were insomnia, fatigue, and pain. Sexual interest and sexual activity were reported to be lower after participation in HDC-ABMT than prior to the procedure. The majority of patients who were employed outside the home prior to HDC-ABMT returned to work with a median time away from work of 48 weeks. CONCLUSIONS: Patients with breast cancer who survive 1 or more years following HDC-ABMT rate their QOL at a relatively high level and frequently return to work. Less than one-third of patients who were interviewed reported moderate to severe symptoms. Problems with sexual functioning were common. IMPLICATIONS: Future research is needed on long-term outcomes after HDC-ABMT and on specific areas of concern, such as sexual functioning.

Adult↗
PubMed2006

Safety climate and self-reported injury: assessing the mediating role of employee safety control.

To further reduce injuries in the workplace, companies have begun focusing on organizational factors which may contribute to workplace safety. Safety climate is an organizational factor commonly cited as a predictor of injury occurrence. Characterized by the shared perceptions of employees, safety climate can be viewed as a snapshot of the prevailing state of safety in the organization at a discrete point in time. However, few studies have elaborated plausible mechanisms through which safety climate likely influences injury occurrence. A mediating model is proposed to link safety climate (i.e., management commitment to safety, return-to-work policies, post-injury administration, and safety training) with self-reported injury through employees' perceived control on safety. Factorial evidence substantiated that management commitment to safety, return-to-work policies, post-injury administration, and safety training are important dimensions of safety climate. In addition, the data support that safety climate is a critical factor predicting the history of a self-reported occupational injury, and that employee safety control mediates the relationship between safety climate and occupational injury. These findings highlight the importance of incorporating organizational factors and workers' characteristics in efforts to improve organizational safety performance.

Accidents, Occupational↗
PubMedDate not supplied

[Health-economic considerations for the use of BMP-2 for spinal surgery in Germany].

INTRODUCTION: BMP-2 can replace autogenous bone grafting in lumbar one-level anterior lumbar interbody fusions (ALIF). The current G-DRG system does not reimburse the upfront price of 2,970 euro per BMP-2 application for hospitals in Germany. The purpose of the current study was to create a health economic model to evaluate the financial savings for health care providers (hospitals) and health care payers (health care insurance) that can be achieved by the use of BMP-2 in spine surgery. METHODS: A previously published pooled data analysis was used in which BMP-2 showed significant improvements in the treatment after ALIF surgery compared to autogenous bone grafting, including earlier return to work time and reduced revision rates. These medical findings were transformed into economic data based on the regulations of the German health system of 2005. RESULTS: The significantly shorter return to work time under BMP-2 treatment generates important financial savings for health care insurances offsetting the upfront prize of 2,970 euro for BMP-2. Savings for hospitals are mainly related to shorter surgery time due to the absence of the bone grafting procedure and faster discharge of the patient. CONCLUSIONS: The combination of improved medical outcome by BMP-2 treatment for the patient and net savings for the entire health care system in Germany represents a "dominant" strategy from a health economic perspective. This implicates that BMP-2 in ALIF procedures is to be recommended from a health economic point of view for the German health care system.

Bone Morphogenetic Protein 2↗
PubMed1993

Is a long delay necessary before appendectomy after appendiceal mass formation? A preliminary report.

The standard treatment for an appendiceal mass is conservative therapy followed by appendectomy after 6 to 10 weeks. With the advent of antibiotics designed to prevent the growth of anaerobes, early appendectomy can now be carried out without complication. The authors studied 56 patients with appendiceal mass formation, 26 (group A) treated conventionally and 30 (group B) treated by early appendectomy. In group B, the infection rate was 17%, the mean operating time was 38.7 minutes, the mean hospital stay was 15 days and there was an early return to work. The corresponding parameters for group A were an infection rate of 8%, a mean operating time of 35.2 minutes, a hospital stay of 19.1 days and a late return to work. Furthermore, 15% of the patients in group A had a recurrent acute episode during the waiting period. Overall, early appendectomy appears to be a safe and cost-effective treatment for appendiceal mass formation.

Abscess↗
PubMed2002

The effect of work status on exclusive breastfeeding in Nairobi.

For many women today work is essential for the economic survival of their families while they also fulfil their role of providing optimum nutrition to their babies through breastfeeding. The objective of the study is to document the effect of returning to work on exclusive breastfeeding by mothers in Kenya. A cross-sectional study of 444 working mothers was undertaken in Nairobi, Kenya. About one half of the mothers were in formal paid employment and the rest were self-employed. The mean number of hours the mothers were away from home due to work was 46.2 hours per week. The prevalence of exclusive breastfeeding was 13.3% at three months. Early introduction of complementary foods was high, with 46.4% of the mothers introducing other foods before one month. Breast milk insufficiency and return to work were the main reasons cited for the cessation of exclusive breastfeeding. In a logistic regression analysis the mode of work (fixed working hours versus shift working hours) was associated with exclusive breastfeeding at one month (OR=0.45) and two months (OR=0.39). Working mothers were able to continue breastfeeding, although the exclusive breastfeeding rates were low. The early introduction of other foods is of public health importance as it exposes infants to increased risk of infection and poor nutrition, particularly diarrhoeal diseases and may lead to flattening of the growth curve. Shift work makes it impossible for some mothers to exclusively breastfeed their infants.

Adult↗
PubMed2003

Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair.

BACKGROUND: The aim was to conduct a meta-analysis of the randomized evidence to determine the relative merits of laparoscopic (LIHR) and open (OIHR) inguinal hernia repair. METHODS: A search of the Medline, Embase, Science Citation Index, Current Contents and PubMed databases identified all randomized clinical trials that compared OIHR and LIHR and were published in the English language between January 1990 and the end of October 2000. The meta-analysis was prepared in accordance with the Quality of Reporting of Meta-analyses (QUOROM) statement. The six outcome variables analysed were operating time, time to discharge from hospital, return to normal activity and return to work, postoperative complications and recurrence rate. Random effects meta-analyses were performed using odds ratios and weighted mean differences. RESULTS: Twenty-nine trials were considered suitable for meta-analysis. Some 3017 hernias were repaired laparoscopically and 2972 hernias were repaired using an open method in 5588 patients. For four of the six outcomes the summary point estimates favoured LIHR over OIHR; there was a significant reduction of 38 per cent in the relative odds of postoperative complications (odds ratio 0.62 (95 per cent confidence interval (c.i.) 0.46 to 0.84); P = 0.002), 4.73 (95 per cent c.i. 3.51 to 5.96) days in time to return to normal activity (P < 0.001), 6.96 (95 per cent c.i. 5.34 to 8.58) days in time to return to work (P < 0.001) and 3.43 (95 per cent c.i. 0.35 to 6.50) h in time to discharge from hospital (P = 0.029). There was a significant increase of 15.20 (95 per cent c.i. 7.78 to 22.63) min in the mean operating time for LIHR (P < 0.001). The relative odds of short-term recurrence were increased by 50 per cent for LIHR compared with OIHR, although this result was not statistically significant (odds ratio 1.51 (95 per cent c.i. 0.81 to 2.79); P = 0.194). CONCLUSION: LIHR was associated with earlier discharge from hospital, quicker return to normal activity and work, and significantly fewer postoperative complications than OIHR. However, the operating time was significantly longer and there was a trend towards an increase in the relative odds of recurrence after laparoscopic repair.

Hernia, Inguinal↗
PubMed2005

Disability management practices in education, hotel/motel, and health care workplaces.

BACKGROUND: The high costs and the impact of work disability have become a growing concern for workplaces. As a result, workplace disability management approaches have been developed to lower disability costs, protect the employability of workers, and promote early return to work. METHODS: A stratified random sample of 455 employers in education (n = 157), hotel/motel (n = 110), and health care (n = 188) sectors who completed a mailed Organizational Policies and Practices (OPP) questionnaire is reported. The OPP questionnaire asked questions about eight workplace disability management practices. The article examined the multi-dimensionality, internal consistency, and discriminant validity of the OPP and compares disability management practices across the three sectors. RESULTS: The OPP questionnaire showed good internal consistency (Cronbach's alpha = 0.95) and discriminant validity. A one-way analysis of variance (ANOVA) for each of the eight subscales demonstrated that there were statistically significant differences between the sectors in ergonomic practices (F (2,452) = 15.8, P < 0.001), disability case management (F (2,452) = 4.6, P < 0.01), return to work (F (2,452) = 10.3, P < 0.001), and people-oriented culture (F (2,452) = 4.5, P < 0.01). CONCLUSIONS: On examining disability management practices in education, hotel/motel, and health care sectors, the OPP seems to be a promising instrument that can be used to assess and monitor how employers are managing disability.

Analysis of Variance↗
PubMed2003

Anal fistulotomy with radiofrequency: a better option to a conventional procedure.

BACKGROUND: Even after the availability of many different surgical options, most surgeons still prefer the classical lay open technique (fistulotomy) as the gold standard for the treatment of anal fistula. This study analyzes the procedure and outcome of radiofrequency fistulotomy over the conventional scalpel method. MATERIAL AND METHODS: Fifty patients with low fistula in ano were analyzed in a prospective study. They were randomized into conventional and radiofrequency fistulotomy groups. Parameters measured included time taken for the procedure, amount of blood loss, postoperative pain, period taken for return to work and recurrence rate. The patients were followed over a period of 30 months. RESULTS: The average time for complete wound healing was 49 days. The patients took a mean period of 7 days to return to their routine. In 7 patients the wounds took more than 80 days to heal and were labeled as delay in wound healing. Two patients developed a recurrence. The comparative study between conventional and radiofrequency fistulotomy showed that procedure time was shorter (p= 0.001); intra operative bleeding was much less (p=0.0004), return to work was earlier (p= 0.029) and wound-healing time was shorter (p=0.0017) in radiofrequency procedure. CONCLUSION: In terms of parameters set for the study, the radiofrequency technique was found to have significant advantages over conventional fistulotomy procedure with regard to operation time, blood loss, return to normal activity and healing of the wounds.

Electrocoagulation↗
PubMed1988

Functional recovery and medical costs of trauma: an analysis by type and severity of injury.

This study was designed to delineate the factors that influence the extent and rate of recovery as related to the characteristics and duration of functional limitations resulting from trauma. The study population was 597 surviving trauma patients aged 16-45 years from two trauma centers in a single state system which follow similar care protocols, and included patients with extremity, abdomen, thorax, brain, and spinal cord injuries. Of 479 trauma patients (80% of the total) who were followed for a full year, 57% had no activity restrictions, 16% had some limitation with either a major or minor physical activity, but did not have any difficulty with mobility or self care, and 27% were limited in either mobility or one of the five basic self-care activities. Further analyses show that of the 262 individuals who were working full-time before the injury, 57% had actually returned to full-time employment within the year. Factors in addition to type and severity of trauma that influence return to work were higher educational level, white collar employment, higher preinjury income, and the presence of supportive individuals among family or friends. Recovery as defined by functional status and return to full-time work is analyzed by body region and severity of the principal injury sustained.

Activities of Daily Living↗