Predictors of Return To Work with Upper Limb Impairment

Introduction
Return to work (RTW) is a key goal in proper management of Upper limb disorders (ULD). Impairments stem from diverse medical etiologies, and numerous variables have some impact on RTW. The abundance of factors, their complex interactions and the diversity in human behavior has made it difficult to pinpoint those at risk, and to efficiently intervene. The aim of this study was to weigh various clinical, functional and occupational parameters that influence return to work (RTW) with upper limb disorders (ULD) and identify significant predictors.

Methods
A retrospective Analysis of 52 workers with ULD referred to an occupational clinic and further examined by occupational therapist. Functional assessment included objective and subjective (DASH-scores) parameters. Quantifying work requirements was based on definitions of the Dictionary of Occupational Titles web site. RTW status was based on follow-up telephone questionnaire.

Results
The only difference was in the DASH-score (p<0.001). Patients who eventually RTW valued their disability as substantially lower (30) than those who didn't (22).

Discussion
Physicians and Rehabilitation staff should regard high DASH-Score as warning sign when assessing RTW prospects. It's advisable to focus on workers with large discrepancy between high DASH and low objective disability and concentrate efforts adequately.