{"title":"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。","authors":"Larry E Miller, Kevin C Chung","doi":"10.1080/17434440.2023.2195549","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The determinants of time to return to activity (RTA) and return to work (RTW) after carpal tunnel release (CTR) remain unclear.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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; I<sup>2</sup>>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; I<sup>2</sup>>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.</p><p><strong>Conclusions: </strong>The time to RTA and RTW after CTR are highly variable and influenced by study-, patient-, and physician-specific factors.</p>","PeriodicalId":12330,"journal":{"name":"Expert Review of Medical Devices","volume":"20 5","pages":"417-425"},"PeriodicalIF":2.9000,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"Determinants of return to activity and work after carpal tunnel release: a systematic review and meta-analysis.\",\"authors\":\"Larry E Miller, Kevin C Chung\",\"doi\":\"10.1080/17434440.2023.2195549\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The determinants of time to return to activity (RTA) and return to work (RTW) after carpal tunnel release (CTR) remain unclear.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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; I<sup>2</sup>>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; I<sup>2</sup>>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.</p><p><strong>Conclusions: </strong>The time to RTA and RTW after CTR are highly variable and influenced by study-, patient-, and physician-specific factors.</p>\",\"PeriodicalId\":12330,\"journal\":{\"name\":\"Expert Review of Medical Devices\",\"volume\":\"20 5\",\"pages\":\"417-425\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2023-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert Review of Medical Devices\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1080/17434440.2023.2195549\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Medical Devices","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1080/17434440.2023.2195549","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
Determinants of return to activity and work after carpal tunnel release: a systematic review and meta-analysis.
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.
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.
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