Research Reports - Work limitations 4 years after mild traumatic brain injury

Arch Phys Med Rehabil. 2017 Aug;98(8):1560-1566. doi: 10.1016/j.apmr.2017.01.010.
Epub 2017 Feb 8.

Theadom A(1), Barker-Collo S(2), Jones K(3), Kahan M(4), Te Ao B(5), McPherson
K(6), Starkey N(7), Feigin V(3); BIONIC4you Research Group.

Collaborators: Feigin V, Theadom A, Barker-Collo S, McPherson K, Kydd R, Barber
PA, Parag V, Brown P, Starkey N, Dowell A, Kahan M, Ameratunga S, Christey G,
Jones K, Jones A, Hardaker N, Te Ao B.

OBJECTIVE: To explore employment status, work limitations, and productivity loss
after mild traumatic brain injury (TBI).
DESIGN: Inception cohort study over 4 years.
SETTING: General community.
PARTICIPANTS: Adults (N=245; >16y at the time of injury) who experienced a mild
TBI and who were employed prior to their injury.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Details of the injury, demographic information, and
preinjury employment status were collected from medical records and self-report.
Symptoms and mood were assessed 1 month postinjury using the Rivermead
Post-Concussion Symptom Questionnaire and the Hospital Anxiety and Depression
Scale. Postinjury employment status and work productivity were assessed 4 years
postinjury using the Work Limitations Questionnaire.
RESULTS: Four years after mild TBI, 17.3% of participants had exited the
workforce (other than for reasons of retirement or to study) or had reduced their
working hours compared with preinjury. A further 15.5% reported experiencing
limitations at work because of their injury. Average work productivity loss was
3.6%. The symptom of taking longer to think 1 month postinjury significantly
predicted work productivity loss 4 years later (β=.47, t=3.79, P≤.001).
CONCLUSIONS: Although changes in employment status and difficulties at work are
likely over time, the results indicate increased unemployment rates, work
limitations, and productivity loss in the longer term after a mild TBI.
Identification of cognitive difficulties 1 month after TBI in working aged adults
and subsequent interventions to address these difficulties are required to
facilitate work productivity. 

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