Systematic Review of Return to Work After Mild Traumatic Brain Injury: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis

Cancelliere, Carol; Kristman, Vicki L.; Cassidy, J. David; Hincapié, Cesar A.; Côté, Pierre; Boyle, Eleanor; Carroll, Linda; Stålnacke, Britt-Marie; Boussard, Catharina Nygren-de; Borg, Jörgen

doi:10.1016/j.apmr.2013.10.010

Cited by 183 publications

(161 citation statements)

References 34 publications

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“…By excessively focusing on difficulties in daily life as a consequence of symptoms and cognitive impairment after MTBI, the intervention could have had a negative impact on the belief in RTW [34]. Vocational rehabilitation is a challenge because work disability is multifactorial and can be due to problems at the individual, environmental and social levels [3]. In our approach, we used an individually tailored model for RTW; however, regular work visits to employers were not performed.…”

Section: Discussionmentioning

confidence: 99%

“…[29] a self-reported 14-item scale and a measure of anxiety and depression. The participants rate each item using a 4-point scale from no distress (0) to too much distress (3). Each subscale of anxiety and depression ranges from 0-21.…”

Section: Patient's Global Impression Of Change (Pgic)mentioning

confidence: 99%

“…According to different cohort studies published, the rate of RTW after one year tends to vary from approximately 55% to 97%, and a systematic review has concluded that the majority of workers seem to RTW within three to six months after MTBI [3,[17][18][19]. Hence, there is still a need for well-designed clinical studies to evaluate the effect of treatments for RTW after MTBI, and it is suggested that further treatment focusing on participation should be individualised [3,4,13,14]. According to other authors additional studies should focus on the timing of the interventions, such as patients with sustainable complaints in the first one to three months after injury [20,21].…”

Section: Introductionmentioning

confidence: 99%

“…Earlier studies reported that the majority of patients suffering MTBI generally recover within twelve months [2]. Approximately 5% to 20% of patients with MTBI experience persistent problems, and persistent post-concussion symptoms (PCS) more often occur in those with more acute symptoms and with emotional stress after MTBI [2,3]. For most patients, follow-up care after MTBI is conducted by a general practitioner (GP) [4].…”

Section: Introductionmentioning

confidence: 99%

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Multidisciplinary outpatient treatment in patients with mild traumatic brain injury: A randomised controlled intervention study

et al. 2017

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Objective: To evaluate the efficacy of a multidisciplinary outpatient follow-up programme compared to follow-up by a general practitioner for patients being at risk or sick-listed with persistent post-concussion symptoms two months after a mild traumatic brain injury. Design: Randomised controlled trial.Patients: One hundred fifty-one patients, 16-56 years.Methods: Multidisciplinary outpatient rehabilitation with individual contacts and a psychoeducational group intervention at two outpatient rehabilitation clinics compared to follow-up by a general practitioner after a multidisciplinary examination. Primary outcome was sustainable return-to-work first year post-injury. Secondary outcomes were post-concussion symptoms, disability, the patient's impressions of change and psychological distress.Results: Days to sustainable return-to-work was 90 in the intervention and 71 in the control group (p=0.375). The number of post-concussion symptoms were fewer in the intervention (6) compared to the control group (8) at 12 months (p=0.041). No group differences were observed for disability (p=0.193), patients impression of change (p=0.285) or psychological distress (p=0.716).2 Conclusion:The multidisciplinary outpatient follow-up programme focusing on better understanding and reassurance of favourable outcome for mild traumatic brain injury did not improve return-to-work, but may have reduced the development of post-concussion symptoms.Additional studies should focus on which factors exhibit a direct impact on return-to-work.

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Section: Discussionmentioning

confidence: 99%

Section: Patient's Global Impression Of Change (Pgic)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Multidisciplinary outpatient treatment in patients with mild traumatic brain injury: A randomised controlled intervention study

et al. 2017

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“…One of the fundamental missions of our Department of neuro-rehabilitation is to provide adequate neurological and/or cognitive rehabilitation treatments in order to to ensure an optimal integration with a priority for returning to work [14].…”

mentioning

confidence: 99%

Occupational Reintegration in Patients with Traumatic Brain Injury

Catano¹,

Robert²,

Houa³

et al. 2015

Int J Neurorehabilitation Eng

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. Incidence of TBI varies greatly between studies. As compared to 98/100,000 in USA or to 160/100,000 in India, it has been reported that the annual incidence of TBI was 235/100,000 in Europe with large disparities among countries: 91/100,000 in Italy, 435/100,000 in England or 546/100,000 in Sweden [3][4][5].In Western countries, one person is victim of a TBI every three minutes, which represents 200,000 victims/year from which 50,000 will be hospitalized, 2,800 will die and 5,000 will keep permanent disabilities [6][7][8]. Th ese fi gures do not include the 15,000 accidents of sport per year which are responsible for various behavioral disorders [9,10].In neuro-rehabilitation practice, diff use cerebral lesions, either of hemorrhagic or of traumatic origin, are generally associated with a coma whose initial severity and duration will determine (a) the chances of survival and (b) the degree of the subsequent recovery [11][12][13]. In survivors, the impacts on the cerebral functioning are numerous and complex, aff ecting motor control, sensory modalities, psychointellectual function, language and writing, recognition of the familiar faces, perception of the environment, … Unfortunately, patients will remain in a state of complete functional dependence for the Activities of Daily Life (ADL) in many cases.Neurological rehabilitation aims primarily to promote the return to independence at home, in the society and at work. One of the fundamental missions of our Department of neuro-rehabilitation is to provide adequate neurological and/or cognitive rehabilitation treatments in order to to ensure an optimal integration with a priority for returning to work [14].Our Department has 100 beds specifi cally intended for the neurological treatments of cerebral injuries. Th e daily care starts from the acute phase of the injury until the functional recovery and the return to autonomy. Continuation of the multidisciplinary treatments as ambulatory cares is provided when necessary. In addition, a AbstractThere is little information on the effi ciencies and limits of the professional reintegration models among patients having suffered from a traumatic brain injury (TBI). In order to identify which factors should be taken into account to establish an accurate individual professional reintegration program, we have studied retrospectively the data from 56 consecutive patients having suffered a TBI with initial loss of consciousness. Our results indicate that many patients evidenced cognitive and executive functions disorders with negative impacts upon employment outcomes. In the patients who returned to work after the TBI, professional reintegration was achieved along with social integration process. Socioeconomic status also appears to affect the possibilities of work recovery as patients with lower levels of education and employment showed a poor outcome in returning to work. Among other positive features, young age at the time of the onset and facilities of arrangement of the work conditions tended to be useful for occupational...

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Employment and Economic Outcomes of Participants With Mild Traumatic Brain Injury in the TRACK-TBI Study

et al. 2022

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IMPORTANCEMild traumatic brain injury (mTBI) may impair the ability to work. Strategies to facilitate return to work are understudied. OBJECTIVE To assess employment and economic outcomes for employed, working-age adults with mTBI in the 12 months after injury and the association between return to work and employer assistance. DESIGN, SETTING, AND PARTICIPANTS Using data from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study, a cohort study of patients with mTBI presenting to emergency departments of 11 level I US trauma centers was performed. Patients with mTBI enrolled in the TRACK-TBI cohort study from February 26, 2014, to May 4, 2016, were followed up at 2 weeks and 3, 6, and 12 months after injury. Work status and income decline of participants were documented in the first year after injury. Associations between work status, injury characteristics, and offer of employer assistance and associations between follow-up care and employer assistance were investigated. Results were adjusted for unobserved outcomes using inverse probability weighting. Data were extracted July 12, 2020; analyses were completed March 24, 2021. Analyses included 435 participants aged 18 to 64 years who were working before the injury, had a Glasgow Coma Scale score of 13 to 15, and completed all postinjury follow-up surveys. MAIN OUTCOMES AND MEASURES Primary outcomes were work status (working or not working) at each study follow-up milestone. Employer assistance included sick leave, reduced hours, modified schedule, transfer to different tasks, assistive technology, and coaching offered during the first 3 months after injury. RESULTSOf 435 participants (147 [34%] female; 320 [74%] White; mean [SD] age 37.3 [12.9] years), 258 (59%) reported not working at 2 weeks after injury and 74 (17%) reported not working at 12 months after injury. More than one-fifth (92 [21%]) experienced a decline in annual income. Work status at 12 months was significantly associated with postconcussion symptoms experienced at 3 months after injury (73% of patients with 3 or more symptoms reported working at 12 months after injury vs 89% of patients with 2 or fewer symptoms; P < .001) but not with other injury characteristics. Participants offered employer assistance in the first 3 months after injury were more likely to report working after injury than those not offered such assistance (at 6 months: 88% vs 78%; P = .02; at 12 months: 86% vs 72%; P = .005). CONCLUSIONS AND RELEVANCEIn this cohort study, mTBI was associated with substantial employment and economic consequences for some patients. Clinicians should systematically follow up with patients with mTBI and coordinate with employers to promote successful return to work.

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Systematic Review of Return to Work After Mild Traumatic Brain Injury: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis

Cited by 183 publications

References 34 publications

Multidisciplinary outpatient treatment in patients with mild traumatic brain injury: A randomised controlled intervention study

Multidisciplinary outpatient treatment in patients with mild traumatic brain injury: A randomised controlled intervention study

Occupational Reintegration in Patients with Traumatic Brain Injury

Employment and Economic Outcomes of Participants With Mild Traumatic Brain Injury in the TRACK-TBI Study

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