Exploratory analysis to identify factors impacting return-to-work outcomes in cases of cumulative trauma disorder.

Current findings suggest that cumulative trauma disorders are multifaceted and have less predictable outcomes than trauma cases. The purpose of this study was to attempt to identify emerging patterns and predictive relationships in this diagnostic group that might be worthy of eventual prospective research. The data source was a comprehensive electronic database containing clinical information collected at point of care over a four-year period. A retrospective analysis was performed on 459 workers' compensation cases with upper extremity cumulative trauma disorders and a subset of 312 with carpal tunnel syndrome. The outcome criterion was return to work as a dichotomous variable. Only two significant correlations with return to work were found: the therapist's estimate of rehabilitation potential and the patient's outcome expectation of the ability to work. Further investigation of the role of beliefs and expectations in the therapeutic process would be a productive area for prospective study.