Interventions to help adults with concussion return to work: A systematic review.

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Occupational Health

Background:

• Clinicians need evidence-based guidance for concussion patients aiming to return to work (RTW).
• Concussion recovery can be complex, impacting a patient's ability to resume work activities.
• Existing literature lacks a synthesized overview of effective RTW interventions and their components.

Purpose of the Study:

• To systematically review interventions aiding return to work (RTW) after concussion.
• To identify effective intervention types: early education, psychological, rehabilitative, and interdisciplinary approaches.
• To determine frequently used and most promising behavior change techniques (BCTs) in concussion RTW interventions.

Main Methods:

• Systematic literature search of MEDLINE ALL, PsycINFO, and CINAHL (2000-2023).
• Inclusion of peer-reviewed adult concussion intervention studies with RTW outcome measures.
• Narrative review of intervention effectiveness and analysis of BCTs using frequency and promise ratios.

Main Results:

• Efficacious interventions may include psychotherapy, neuropsychological training, vestibular/vision rehabilitation, exercise, and cognitive/vocational support.
• The BCT 'information about health consequences' was frequently used.
• Effective BCTs involved instruction, reducing negative emotions, action planning, and problem-solving.

Conclusions:

• Practitioners can consider identified promising interventions and BCTs for concussion RTW support.
• This review provides a foundation for developing targeted strategies to facilitate patient reintegration into the workforce.
• Further research may refine the application of specific BCTs within concussion rehabilitation programs.