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

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.