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Supportive Elements and Challenges to Return to Work Following a Concussion: A Scoping Review.

Maryam Shahzad1, Joyce Lo, Beatrice Yuen

  • 1Author Affiliations: Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Ms Shahzad, Dr Reed); Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Ms Shahzad, Ms Lo, Ms Yuen, Dr Duncan, Dr Reed, Dr Nowrouzi-Kia); Krembil Research Institute-University Health Network, Toronto, Ontario, Canada (Dr Nowrouzi-Kia); and Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, Ontario, Canada (Dr Nowrouzi-Kia).

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Summary

Returning to work after a concussion involves personal, medical, and workplace factors. Understanding these facilitators and barriers is key to improving the return-to-work (RTW) process for individuals with concussion.

Keywords:
biopsychosocialbrain concussionpost-concussion syndromerehabilitationreturn to workvocational

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Area of Science:

  • Neuroscience
  • Occupational Health
  • Rehabilitation Medicine

Background:

  • Concussion, a common brain injury, significantly impacts an individual's ability to return to work (RTW).
  • Facilitators and barriers to RTW post-concussion are complex and multifactorial.
  • A comprehensive understanding of these factors is crucial for effective intervention strategies.

Purpose of the Study:

  • To conduct a scoping review of facilitators and barriers influencing the RTW process after concussion.
  • To explore these factors across the domains of the individual, medical system, funder, and workplace.
  • To synthesize current evidence to inform clinical practice and future research.

Main Methods:

  • Scoping review of CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science databases up to April 6, 2024.
  • Inclusion of English-language studies examining RTW factors post-concussion.
  • Data extraction, numerical analysis, and deductive content analysis following PRISMA-ScR guidelines.

Main Results:

  • Twenty studies were included, identifying 4 main themes: the person, medical system, funder, and workplace.
  • Supportive elements included individualized rehabilitation, graduated RTW, and personal agency.
  • Challenges encompassed lack of patient education, delayed services, and isolating workplace accommodations.

Conclusions:

  • The RTW process post-concussion is shaped by a complex interplay of supportive elements and challenges.
  • Findings offer insights for optimizing RTW outcomes and supporting workforce re-entry.
  • Future research should focus on policies, long-term outcomes, and integrated support systems.