Research Reports - Work limitations four years following mild traumatic brain injury

Arch Phys Med Rehabil. 2017 Feb 7. pii: S0003-9993(17)30067-9. doi:
10.1016/j.apmr.2017.01.010. [Epub ahead of print]

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

OBJECTIVE: To explore employment status, work limitations and productivity loss
following mild traumatic brain injury (TBI).
STUDY DESIGN: Inception cohort study over four years.
SETTING: General community.
PARTICIPANTS: 245 Adults (>16 years 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 pre-injury employment status were collected from
medical records and self-report. Symptoms and mood were assessed one-month
post-injury using the Rivermead Post-Concussion Symptom Questionnaire and the
Hospital Anxiety and Depression Scale. Post-injury employment status and work
productivity were assessed four-years post-injury using the Work Limitations
Questionnaire.
RESULTS: Four-years following 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 to pre-injury. A further 15.5% reported experiencing
limitations at work as a result of their injury. Average work productivity loss
was 3.6% The symptom of 'taking longer to think' one month post-injury
significantly predicted work productivity loss four years later (β = 0.47, t =
3.79, p = <0.001).
CONCLUSIONS: Whilst 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 following a mild TBI.
Identification of cognitive difficulties one month following TBI in working aged
adults and subsequent interventions to address these difficulties are required to
facilitate work productivity. 

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