Work Limitations 4 Years After Mild Traumatic Brain Injury: A Cohort Study

Feigin, Valery L.; Theadom, Alice; Barker‐Collo, Suzanne; McPherson, Kathryn; Kydd, Robert R.; Barber, P Alan; Parag, Varsha; Brown, Paul; Starkey, Nicola J.; Dowell, Anthony; Kahan, Michael; Ameratunga, Shanthi; Christey, Grant; Jones, Kelly; Jones, Amy; Hardaker, Natalie; Ao, Braden Te

doi:10.1016/j.apmr.2017.01.010

Cited by 79 publications

(54 citation statements)

References 24 publications

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“…No significant between-group differences were found in household tasks, learning, community life, emotional functions, concentrating, dealing with strangers, or maintaining friendships, where impairment was rated as around moderate in all 3 patient groups. This study is in line with previous studies showing a high proportion of residual complaints in patients with TBI, even in those with miTBI and even after years of injury (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Based on our results, the functioning assessments by patients, significant others and treating neurologists were largely in line and thus probably also reliable.…”

Section: Discussionsupporting

confidence: 92%

“…When patients with different injuries are evaluated, TBIs cause the most severe health issues (4) and long-lasting consequences for both physical and mental health (5,6) irrespective of the severity of injury (7). Even mild TBI (miTBI) may cause a diversity of problems in cognitive and emotional functions, energy and drive, and in carrying out daily routines and work (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

mentioning

confidence: 99%

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Usability of World Health Organization Disability Assessment Schedule in chronic traumatic brain injury

Tarvonen-Schröder¹,

Tenovuo²,

Kaljonen³

et al. 2018

J Rehabil Med

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

Usability of World Health Organization Disability Assessment Schedule in chronic traumatic brain injury

Tarvonen-Schröder¹,

Tenovuo²,

Kaljonen³

et al. 2018

J Rehabil Med

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“…These findings compliment previous research which has highlighted the impact of mild-TBI on work productivity four years after mild-TBI. [ 6 , 25 ] Indeed, a changing sense of self, needing to manage limitations caused by the TBI symptoms and needing support to cope with the unpredictability of the future have been important factors affecting employment following mild-TBI. The current findings highlight that the impact of mild-TBI extends beyond paid employment and also affects wider community participation.…”

Section: Discussionmentioning

confidence: 99%

“…These include cognitive (e.g., difficulty concentrating and taking longer to think), somatic (e.g., headaches, fatigue or dizziness) and emotional symptoms (e.g., feeling irritable, frustrated or restless). [ 5 ] Cognitive symptoms have been linked to reduced productivity at work,[ 6 , 7 ] higher health service use, and engagement in antisocial behaviour. [ 8 ] Whilst many recover naturally from mild-TBI within weeks or months of the injury,[ 9 , 10 ] evidence has now revealed that symptoms can persist for between 24% and 48% of those experiencing a mild-TBI one year post-injury.…”

Section: Introductionmentioning

confidence: 99%

Population-based cohort study of the impacts of mild traumatic brain injury in adults four years post-injury

et al. 2018

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There is increasing evidence that some people can experience persistent symptoms for up to a year following mild TBI. However, few longitudinal studies of mild TBI exist and the longer-term impact remains unclear. The purpose of this study is to determine if there are long-term effects of mild traumatic brain injury (TBI) four-years later. Adults (aged ≥16 years) identified as part of a TBI incidence study who experienced a mild-TBI four-years ago (N = 232) were compared to age-sex matched controls (N = 232). Sociodemographic variables, prior TBI and symptoms were assessed at the time of injury. Four years post-injury participants completed the Rivermead Post-Concussion Symptom Questionnaire, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index and the Participation Assessment with Recombined Tools. Analysis of covariance was used to compare differences between TBI cases four years post-injury and controls, controlling for prior TBI and depression. A multiple regression model was used to identify the predictors of increased symptoms and reduced participation. The mild-TBI sample experienced significantly increased self-reported cognitive symptoms (F = 19.90, p = <0.01) four years post-injury than controls. There were no differences between the groups for somatic (F = 0.02, p = 0.89) or emotional symptoms (F = 0.31, p = 0.58). Additionally, the mild-TBI group reported significantly poorer community participation across all three domains: productivity (F = 199.07, p = <0.00), social relations (F = 13.93, p = <0.00) and getting out and about (F = 364.69, p = <0.00) compared to controls. A regression model accounting for 41% of the variance in cognitive symptoms in TBI cases revealed a history of TBI, receiving acute medical attention and baseline cognitive symptoms, sleep quality, anxiety and depression were predictive of outcome. The results indicate that whilst somatic and emotional symptoms resolve over time, cognitive symptoms can become persistent and that mild TBI can impact longer-term community participation. Early intervention is needed to reduce the longer-term impact of cognitive symptoms and facilitate participation.

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“…15 Traditionally, mTBI has been thought to require minimal clinical management beyond watchful waiting. 16 In response to mounting evidence that mTBI can be associated with chronic symptoms and disability, [17][18][19][20] standards for mTBI care have evolved to promote earlier and more proactive intervention. [21][22][23][24] Numerous expert agreement statements and clinical practice guidelines have been published within the last 5 years.…”

mentioning

confidence: 99%

Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines

Silverberg

Iaccarino

Panenka

et al. 2020

Archives of Physical Medicine and Rehabilitation

226

133

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At least 3 million Americans sustain a mild traumatic brain injury (mTBI) each year, and 1 in 5 have symptoms that persist beyond 1 month. Standards of mTBI care have evolved rapidly, with numerous expert consensus statements and clinical practice guidelines published in the last 5 years. This Special Communication synthesizes recent expert consensus statements and evidenced-based clinical practice guidelines for civilians, athletes, military, and pediatric populations for clinicians practicing outside of specialty mTBI clinics, including primary care providers. The article offers guidance on key clinical decisions in mTBI care and highlights priority interventions that can be initiated in primary care to prevent chronicity.

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Work Limitations 4 Years After Mild Traumatic Brain Injury: A Cohort Study

Cited by 79 publications

References 24 publications

Usability of World Health Organization Disability Assessment Schedule in chronic traumatic brain injury

Usability of World Health Organization Disability Assessment Schedule in chronic traumatic brain injury

Population-based cohort study of the impacts of mild traumatic brain injury in adults four years post-injury

Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines

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