title: Predictors of return to work with upper limb disorders.
abstract: BACKGROUND
  Return to work (RTW) is a key goal in the proper management of upper limb disorders (ULDs). ULDs stem from diverse medical aetiologies and numerous variables can affect RTW. The abundance of factors, their complex interactions and the diversity of human behaviour make it difficult to pinpoint those at risk of not returning to work (NRTW) and to intervene effectively.
  
  
  OBJECTIVE
  To weigh various clinical, functional and occupational parameters that influence RTW in ULD sufferers and to identify significant predictors.
  
  
  METHODS
  A retrospective analysis of workers with ULD referred to an occupational health clinic and further examined by an occupational therapist. Functional assessment included objective and subject ive [Disability of the Arm, Shoulder and Hand (DASH) score] parameters. Quantification of work requirements was based on definitions from the Dictionary of Occupational Titles web site. RTW status was confirmed by a follow-up telephone questionnaire.
  
  
  RESULTS
  Among the 52 subjects, the RTW rate was 42%. The DASH score for the RTW group was 27 compared with 56 in the NRTW group (P < 0.001). In multivariate analyses, only the DASH score was found to be a significant independent predictor of RTW (P < 0.05).
  
  
  CONCLUSIONS
  Physicians and rehabilitation staff should regard a high DASH score as a warning sign when assessing RTW prospects in ULD cases. It may be advisable to focus on workers with a large discrepancy between high DASH scores and low objective disability and to concentrate efforts appropriately.
authors.affiliation: Occupational Medicine Department, Maccabi Healthcare Services, 5840419 Holon, Israel, Environmental and Occupational Health Department, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel, shlomo.moshe@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Moshe
authors.affiliation: Occupational Therapy Department, Maccabi HealthCare Services, 5836111 Holon, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Izhaki
authors.affiliation: Environmental and Occupational Health Department, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel, Siaal Research Center for Family Practice and Primary Care, Community Health Division, Ben-Gurion University of the Negev, 8410501 Beer-Sheva, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Chodick
authors.affiliation: Occupational Medicine Department, Maccabi Healthcare Services, 5840419 Holon, Israel, Environmental and Occupational Health Department, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel.
authors.forename: N
authors.initials: N
authors.lastname: Segal
authors.affiliation: Siaal Research Center for Family Practice and Primary Care, Community Health Division, Ben-Gurion University of the Negev, 8410501 Beer-Sheva, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Yagev
authors.affiliation: Department of Orthopedics, Assaf Harofeh Medical Center, 7030000 Zerifin, Israel.
authors.forename: A S
authors.initials: AS
authors.lastname: Finestone
authors.affiliation: Occupational Medicine Department, Maccabi Healthcare Services, Central District, 6812509 Tel Aviv, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Juven
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D012189:Retrospective Studies; D062707:Return to Work; D018582:Sick Leave; D011795:Surveys and Questionnaires; D034941:Upper Extremity; D014937:Work
keywords: Incapacity for work; musculoskeletal; occupational fitness; sickness absence; upper limb disorder.