Return to Work After Hand Injury: the Role of Medical, Demographic and Psycho-Social Factors

Study Overview
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Brief Summary
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The purpose of this study is to investigate the extent of return to work (RTW) after traumatic hand injury and to identify factors that are related to RTW.

Detailed Description
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RTW is one of the main rehabilitation outcomes after injury, the loss of the ability to work may have psychological as well as economic impact on the injured person. Time off work is also a burden to the economic system, associated with loss of work days, sick leave and national insurance payment. Hand injury can cause limitations in function, therefore influence the ability to work. Review of the literature reveals that time off work after hand injury ranges from a few days to a year and more. Factors associated with time off work include medical, socio-economic and psychosocial factors. Only a few studies have been conducted in Israel to investigate rate of RTW after hand injury and factors that affect RTW . The aim of this study is to explore the extent of RTW after traumatic hand injury and to examine the relationship between several factors - medical, demographic and psychosocial and RTW. This, in order to identify prognostic factors that can be treated during rehabilitation. There is no preliminary hypothesis made about the relationships between the factors and RTW. This study is also retrospective and prospective since it examine individuals under-going occupational therapy treatment and individuals who have been treated in the past.

Official Title
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Return to Work After Hand Injury: The Role of Medical, Demographic and Psychosocial Factors

Conditions
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Hand Injury

Intervention / Treatment
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* Behavioral: Questionnaires and motor/sensitivity testing
* Behavioral: Questionnaires and motor/sensitivity testing
* Behavioral: Questionnaires and motor/sensitivity testing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The individual worked until he/she was injured Traumatic hand injury including: wrist fractures, fingers fractures, tendon injury, nerve injury, Crush injury, finger amputation Exclusion Criteria: Non traumatic hand injury (such as CTS) Mallet finger Burns Injury in several organs

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| A<br>Group A - 25 individuals or more, that start occupational therapy and agree to participate in the research. | Behavioral: Questionnaires and motor/sensitivity testing<br>* Group A: Full assessment (using the various measures described) will be carried out 0-3 weeks since referral. Treatment will focus on the patient's needs and in accordance with the physicians requests. Three months post initial treatment re-assessment will be conducted.<br>|
| B<br>Group B- 25 individuals or more, half a year after hand injury that were treated in occupational therapy at the same institute. | Behavioral: Questionnaires and motor/sensitivity testing<br>* Group B Researcher will contact by phone previous patients that were treated in the occupational therapy department in the past half year and a year, in order to get their permission to participate (retrospectively) in this research. After getting their consent, a questionnaire concerning their RTW will be posted to the subjects.<br>|
| C<br>Group C - 25 individuals or more, a year after hand injury that were treated in occupational therapy at the same institute | Behavioral: Questionnaires and motor/sensitivity testing<br>* Group C Researcher will contact by phone previous patients that were treated in the occupational therapy department in the past half year and a year, in order to get their permission to participate (retrospectively) in this research. After getting their consent, a questionnaire concerning their RTW will be posted to the subjects.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| RTW vs no RTW |  | Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medical, socio-demographic and work environment questionnaires |  | Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury. | 
| psychosocial questionnaires including: Post Traumatic Stress Disorder questionnaire, McGill Pain Questionnaire, pain belief and self-efficacy questionnaires. |  | Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury. | 
| Motor and sensitivity testing : hand grip and pinch strength measurements, Purdue Pegboard Test, Semmes-Weinstein Pressure Monofilaments, upper extremity rang of motion, Pain Visual Analogue Scale. |  | within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment . | 
| Disabilities of Arm Shoulder and Hand questionnaire |  | Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury. |