title: Systematic Review of Prognostic Factors for Return to Work in Workers with Sub Acute and Chronic Low Back Pain.
abstract: Purpose We systematically reviewed the evidence on factors that predict duration of sick leave in workers after 6 weeks low back pain (LBP) related sick leave. We hypothesized that different factors affect the duration of the leave depending on the time away from work. Methods The review occurred in seven phases: (1) developing the central question, (2) conducting the literature search, (3) identifying relevant publications, (4) quality appraisal, (5) data extraction, (6) evidence synthesis, and (7) knowledge translation. We searched for studies that reported episodes of LBP and sick leave that lasted more than 6 weeks. All included studies reported at least one prognostic factor where return to work was the outcome. Results We identified twenty-two relevant publications. The impact of pain, functional status and radiating pain seems to change with duration of work disability. Workers' recovery expectations remain important after 6 weeks. Modified duties are rarely studied in later phases of work disability. Depression/mental health did not appear to be an important factor in later phases. Workplace physical factors remain important. There is insufficient evidence that pain catastrophising and fear avoidance are predictive factors in later phases. There was moderate evidence for age in the later phases. Functional capacity and claim related factors were supported by some evidence. Discusion Physical demands in the workplace are preventing workers from getting back to work in a timely fashion across phases. The psychosocial work environment is understudied in later phases. Overall, we cannot conclude that prognostic factors change over time.
authors.affiliation: Institute for Work and Health, Toronto, ON, Canada. ivan.steenstra@ryerson.ca.|Ted Rogers School of Management, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada. ivan.steenstra@ryerson.ca.
authors.forename: Ivan A
authors.identifier: 0000-0002-1262-9741
authors.initials: IA
authors.lastname: Steenstra
authors.affiliation: Institute for Work and Health, Toronto, ON, Canada.
authors.forename: Claire
authors.initials: C
authors.lastname: Munhall
authors.affiliation: Institute for Work and Health, Toronto, ON, Canada.
authors.forename: Emma
authors.initials: E
authors.lastname: Irvin
authors.affiliation: University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Nelson
authors.initials: N
authors.lastname: Oranye
authors.affiliation: University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Steven
authors.initials: S
authors.lastname: Passmore
authors.affiliation: Institute for Work and Health, Toronto, ON, Canada.
authors.forename: Dwayne
authors.initials: D
authors.lastname: Van Eerd
authors.affiliation: Institute for Work and Health, Toronto, ON, Canada.
authors.forename: Quenby
authors.initials: Q
authors.lastname: Mahood
authors.affiliation: Institute for Work and Health, Toronto, ON, Canada.
authors.forename: Sheilah
authors.initials: S
authors.lastname: Hogg-Johnson
mesh_terms: D059787:Acute Pain / Q000523:psychology / Q000534:rehabilitation*; D000367:Age Factors; D059350:Chronic Pain / Q000523:psychology / Q000534:rehabilitation*; D004185:Disability Evaluation; D015601:Injury Severity Score; D017116:Low Back Pain / Q000523:psychology / Q000534:rehabilitation*; D011379:Prognosis; D062707:Return to Work / Q000523:psychology / Q000706:statistics & numerical data*; D057566:Self Report; D012737:Sex Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D013997:Time Factors
keywords: Disability; Disability evaluation; Prognosis; Review; Sick leave; Systematic