Predictors for Return to Work in Subjects with Mild Traumatic Brain Injury

Abstract

Objective. To predict return to work (RTW) at 12 months for patients who either were sick-listed or were at risk to be sick-listed with persistent postconcussion symptoms (PCS) at six to eight weeks after injury. Method. A prospective cohort study of 151 patients with mild traumatic brain injury (MTBI) admitted consecutively to outpatient clinics at two University Hospitals in Norway. The study was conducted as part of a randomised clinical trial. Injury characteristics were obtained from the medical records. Sick leave data from one year before to one year after MTBI were obtained from the Norwegian Labour and Welfare Service. Self-report questionnaires were used to obtain demographic and symptom profiles. Results. We observed a significant negative association between RTW at 12 months and psychological distress, global functioning, and being sick-listed at two months after MTBI, as well as having been sick-listed the last year before injury. Conclusion. Psychological distress, global functioning postinjury, and the sick leave trajectory of the subjects were negative predictors for RTW. These findings should be taken into consideration when evaluating future vocational rehabilitation models.

Predicting Outcome 12 Months after Mild Traumatic Brain Injury in Patients Admitted to a Neurosurgery Service

“…Additionally, we excluded patients with severe mental illness. Being sick-listed before injury as a measure of preinjury functioning has been shown to contribute to postinjury functioning measured as return to work (73). However, in the present study, work status (yes/no) did not contribute uniquely to outcome above the other preinjury predictors.…”

Physical Therapy Management of Adults with Mild Traumatic Brain Injury

“…7,8 As crucial as a return to sport is for an injured athlete, return to work, school, family responsibilities, and avocations is important to nonathletes with mTBI. 9 This paper summarizes how physical therapists (PTs) evaluate and treat adults after mTBI and collaborate with speech-language pathologist (SLP) in the care of these individuals. Of importance for SLP is the influence that vestibular dysfunction has on the cognitive resources, vigilance, and potential difficulty reading due to the persistent dizziness.…”

“…Mood swings and frustration are also common. 2,4,9 Typically, neuroimaging studies are negative, leaving the professionals to rely on standardized assessments in the minutes and hours immediately postinjury. A summary of the clinical and psychometric properties of the most common standardized tests used immediately after injury is found in Table 1.…”

“…A summary of the clinical and psychometric properties of the most common standardized tests used immediately after injury is found in Table 1. [9][10][11][12][13][14][15][16] Most mTBIs appear to resolve with the individual reporting no symptoms in 15 to 20 days after prescribed rest and gradual return to activity and regular daily routines. However, in sports-related concussion, 5 to 20% develop postconcussion syndrome (PCS).…”

“…However, in sports-related concussion, 5 to 20% develop postconcussion syndrome (PCS). 9 There is no precise definition of PCS, though the National Institute of Neurologic Disorders and Stroke 17 proposes that it is "a complex, poorly understood problem that may cause headache after head injury; in most cases, patients cannot remember the event that caused the concussion and a variable period of time prior to the injury." Concussion symptoms that persist beyond 21 days are one operational definition of PCS.…”