Determinants of return to activity and work after carpal tunnel release: a systematic review and meta-analysis.

IF 2.9 3区医学 Q3 ENGINEERING, BIOMEDICAL Expert Review of Medical Devices Pub Date : 2023-05-01 DOI:10.1080/17434440.2023.2195549

Larry E Miller, Kevin C Chung

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引用次数: 3

Abstract

Introduction: The determinants of time to return to activity (RTA) and return to work (RTW) after carpal tunnel release (CTR) remain unclear.

Methods: We performed a systematic review of studies published from January 2000 to November 2022 involving patients treated with open (OCTR), mini-open (mOCTR), or endoscopic (ECTR) CTR and reporting RTA or RTW. The time to RTA and RTW were estimated using a random-effects meta-analysis model. Subgroup analysis and multivariable meta-regression explored sources of heterogeneity in outcomes.

Results: A total of 7386 patients in 48 studies (63 groups) were included, with 24 groups (4541 patients) treated with OCTR, 16 groups (1085 patients) treated with mOCTR, and 23 groups (1760 patients) treated with ECTR. Among 15 studies (20 groups) reporting RTA, the mean was 13.1 days (95% CI, 9.9-16.3; I²>99%). Shorter duration of postoperative activity restriction guidance was associated with faster RTA. Among 43 studies (58 groups) reporting RTW, the mean was 23.4 days (95% CI, 21.4-25.3; I²>99%). Procedure type (mOCTR and ECTR compared to OCTR), prospective study design, and smaller proportion of patients receiving disability benefit were associated with faster RTW.

Conclusions: The time to RTA and RTW after CTR are highly variable and influenced by study-, patient-, and physician-specific factors.

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腕管释放后恢复活动和工作的决定因素:系统回顾和荟萃分析。

导读:腕管释放(CTR)后恢复活动(RTA)和恢复工作(RTW)时间的决定因素尚不清楚。方法:我们对2000年1月至2022年11月发表的研究进行了系统回顾，涉及采用开放式(OCTR)、微型开放式(mOCTR)或内窥镜(ECTR) CTR治疗并报告RTA或RTW的患者。采用随机效应荟萃分析模型估计RTA和RTW的时间。亚组分析和多变量元回归探讨了结果异质性的来源。结果:共纳入48项研究(63组)7386例患者，其中OCTR治疗24组(4541例)，mOCTR治疗16组(1085例)，ECTR治疗23组(1760例)。在报告RTA的15项研究(20组)中，平均为13.1天(95% CI, 9.9-16.3;I2 > 99%)。术后活动限制指导时间越短，RTA越快。在报告RTW的43项研究(58组)中，平均为23.4天(95% CI, 21.4-25.3;I2 > 99%)。手术类型(mOCTR和ECTR与OCTR相比)、前瞻性研究设计和接受残疾福利的患者比例较小与更快的RTW相关。结论:CTR后到RTA和RTW的时间是高度可变的，受研究、患者和医生特异性因素的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Medical Devices 医学-工程：生物医学

CiteScore

5.90

自引率

3.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal serves the device research community by providing a comprehensive body of high-quality information from leading experts, all subject to rigorous peer review. The Expert Review format is specially structured to optimize the value of the information to reader. Comprehensive coverage by each author in a key area of research or clinical practice is augmented by the following sections: Expert commentary - a personal view on the most effective or promising strategies Five-year view - a clear perspective of future prospects within a realistic timescale Key issues - an executive summary cutting to the author''s most critical points In addition to the Review program, each issue also features Medical Device Profiles - objective assessments of specific devices in development or clinical use to help inform clinical practice. There are also Perspectives - overviews highlighting areas of current debate and controversy, together with reports from the conference scene and invited Editorials.