Return to work after traumatic brain injury: Cohort comparison and economic evaluation

Radford, Kathryn; Phillips, Julie; Drummond, Avril; Sach, Tracey; Walker, Marion F; Tyerman, Andy; Haboubi, Naseer; Jones, Trevor

doi:10.3109/02699052.2013.766929

Cited by 73 publications

(73 citation statements)

References 46 publications

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“…Similar to other authors, we found a tendency for less frequent health care use among patients receiving multidisciplinary treatment [37,40]. This finding could be by chance, but the use of other health care services by patients receiving multidisciplinary treatment must be investigated in other studies.…”

Section: Discussionsupporting

confidence: 90%

“…Several authors have suggested that a structured RTW protocol that includes work visits might be beneficial in determining the gap between the patients' capabilities and their work requirements [35,36]. By conducting early standardised visits to the workplace to optimise RTW and by focusing on a gradual exposure to activities upon RTW, as recommended by Radford et al, we assume that RTW would improve [37]. Finally, it is recommended that early vocational rehabilitation be integrated into the early rehabilitation process [35,38].…”

Section: Discussionmentioning

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: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…Evidence from 2 Level I studies [45,46] and 2 Level II studies [47,48] reported on the benefit of cognitive interventions to accelerate RTW. In these studies, cognitive interventions were focused on improving memory, post-concussive symptoms, and neuropsychological functioning.…”

Section: Cognitive Rehabilitation Facilitate Return To Work Post Traumentioning

confidence: 99%

Cognition and return to work after mild/moderate traumatic brain injury: A systematic review

Mani¹,

Cater

Hudlikar

2017

WOR

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Abstract. BACKGROUND:Approximately two percent of the United States population are traumatic brain injury (TBI) survivors. The unemployment rate among them is substantial. Cognitive skills are essential to perform any job. OBJECTIVE: We analyzed the literature on cognitive rehabilitation (CR) related to mild/moderate TBI to learn the influence of cognition on return to work (RTW) post TBI. METHODS:We conducted a systematic review of the studies on CR related to RTW post TBI that were published between 2000 and 2015. RESULTS: We critically reviewed 30 studies that met the inclusion criteria. Ten studies highlighted cognition as a predictor variable, seven studies demonstrated support for cognitive testing in RTW assessments, and 13 studies showed the efficacy of CR in facilitating RTW post TBI. CONCLUSION: Cognition plays a significant role in predicting and facilitating RTW in patients with TBI.

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“…33 However, the point at which connectivity profiles are stabilized has yet to be identified, and it is plausible that connectivity alterations evident early after injury might endure beyond a critical early window of clinical recovery, typically regarded as the first year postinjury. [34][35][36][37] In the present investigation, we probed longitudinal connectivity changes in a subset of individuals from our TBI group, comparing connectivity profiles derived from rs-fMRI in the subacute phase (approximately 3 months postinjury) to those in the chronic phase. Our aim was to outline the developmental trajectory of any identified changes between the TBI and HC groups, as well as to examine whether functional connectivity changes during the chronic phase are gradually evolving phenomena or if they are relatively more immediate effects of brain injury.…”

mentioning

confidence: 99%

Chronology and Chronicity of Altered Resting-State Functional Connectivity after Traumatic Brain Injury

Venkatesan

Dennis

Hillary

2015

Journal of Neurotrauma

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Whereas traumatic brain injury (TBI) results in widespread disruption of neural networks, changes in regional resting-state functional connectivity patterns after insult remain unclear. Specifically, little is known about the chronology of emergent connectivity alterations and whether they persist after a critical recovery window. We used resting-state functional magnetic resonance imaging and seed-voxel correlational analyses in both cross-sectional and longitudinal designs to probe intrinsic connectivity patterns involving the posterior cingulate cortex (PCC) and hippocampi, regions shown to be important in the default mode network (DMN) and vulnerable to neuropathology. A total of 22 participants in the chronic stage of moderateto-severe TBI and 18 healthy controls were included for cross-sectional study. Longitudinal analyses included 13 individuals in the TBI group for whom data approximately 3 months after injury (subacute) were available. Overall, results indicated dissociable connectivity trajectories of the PCC and hippocampi during recovery from TBI, with PCC alterations characterized by early hypersynchrony with the anterior DMN that is gradually reduced, and hippocampal changes marked by increasing synchrony with proximal cortex and subcortex. The PCC also showed increasing antiphase synchrony with posterior attentional regions, and the hippocampi showed decreasing antiphase synchrony with frontal attentional regions. Antiphase synchrony of the hippocampus and dorsolateral prefrontal cortex at the subacute stage of TBI was positively associated with attentional performance on neuropsychological tests at both the subacute and chronic stages. Our findings highlight the heterogeneity of regional whole-brain connectivity changes after TBI, and suggest that residual connectivity alterations exist in the clinically stable phase of TBI. Parallels between the chronicity of the observed effects and findings in neurodegenerative disease are discussed in the context of potential long-term outcomes of TBI.

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Return to work after traumatic brain injury: Cohort comparison and economic evaluation

Cited by 73 publications

References 46 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

Cognition and return to work after mild/moderate traumatic brain injury: A systematic review

Chronology and Chronicity of Altered Resting-State Functional Connectivity after Traumatic Brain Injury

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