Principles for Easing Return to Work after mTBI

Employment is an important part of life for adults and even older youth. For the 10-15% of those that don’t recover as expected following a concussion/mTBI, return to work can be challenging due to possible physical, cognitive and emotional symptoms. Return to work (RTW) is a major indicator of real world functioning; thus, predicting future work success and helping to make it happen is a major area of importance.

This project had the goal to identify and categorize literature on RTW in health conditions to determine if principles used for successful RTW in other health conditions might be applied in MTBI.

A search was conducted of peer-reviewed literature in a number of electronic databases. Grey literature was also identified from from government, labour and community organization’s websites. A lengthy process began with identifying 36,468 listings from the electronic databases and 28,696 listings identified from the grey literature. This was followed by three levels of screening, quality assessment of the literature, excluding duplications and articles that weren’t relevant, and then pulling out the relevant information.

The results suggest that a biopsychosocial approach needs to be applied to improve RTW outcomes after Concussion/mTBI. Factors in all three domains of the biopsychosocial model were found to be associated with RTW, including pain severity (biological), communication and social support (social), and expectations of recovery and RTW (psychological). Many of these factors are modifiable and can be addressed by a concerted effort from family members and friends,colleagues, employers, health care providers and case coordinators. The findings also support the Institute of Work and Health (IWH) seven RTW principles, that they can be applied across different health conditions.

To view a list of factors associated with better/worse return to work outcomes, and those having no effect on outcomes, click here.

Reference: Cassidy JC, Cancelliere C, Donovan J. Stockendahl M, Biscardi M & Ammendolia, C. Principles for Easing Return to Work after mTBI. Final report submitted to the Ontario Neurotrauma Foundation, May 2014.