Traumatisme crânien cérébral léger (TCCL)

Purpose The study approach sought to understand which vocational rehabilitation (VR) strategies are available for individuals seeking return to work (RTW) following traumatic brain injury (TBI). Secondly, the review aimed to identify how these RTW interventions and outcomes are evaluated. Methods Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, the scoping review began by identifying relevant English language articles via PubMed, CINAHL, PsycINFO, and Embase databases for peer-reviewed journal articles published from January 2013 to September 2021. The review focused on identifying studies with a sample population of people with moderate to severe TBI. Results A total of 23 studies met the search criteria. For each included study, the following data were extracted: (a) country of origin, (b) sample size, (c) civilian or military sample population, (d) age, (e) participant gender, (f) RTW definition, (g) intervention approach, and (h) RTW outcome. The results were synthesized by placement into one of four categories as a function of the study's underlying methodological approach. Conclusions The development of effective RTW approaches has largely been neglected in the rehabilitation literature for persons with TBI in civilian and military populations. Effective strategies do exist to help guide efforts to return this population to productive activity, including work. Implications for Rehabilitation: Lack of productive engagement in work and school among persons with traumatic brain injury (TBI) presents a chronic challenge in rehabilitation systems internationally. Rehabilitation professionals should utilize multidisciplinary and integrated return-to-work (RTW) interventions given the varied areas of function that can result from TBI. Rehabilitation professionals should apply RTW interventions that promote on-site training and workplace integration. Given the idiosyncratic nature of TBI, RTW interventions should be tailored to meet the specific needs of the person seeking support.

© Petty J; McLennan V; Kendall E; Degeneffe CE. Disability & Rehabilitation. 46(15):3243-3255, 2024 Jul.

Purpose To examine challenges in return to work (RTW) for persons with persistent postconcussion symptoms (PPCS) experienced by the affected employees and their managers. Methods A survey of employees (S-E) and two surveys of managers (S-M1, S-M2) executed 4 months apart to capture the time perspective. Inclusion: Adults aged 18-66 with PPCS > 4 weeks, employed at the time of mTBI who returned to work within the previous year. Managers involved in their RTW process. Outcome measures: Work status, working hours, work functioning (Work Role Functioning Questionnaire, WRFQ), work productivity. Results Ninety-two employees and 66 managers were recruited. Three-fourths of the employees had returned to work but only one-third worked under similar conditions. Weekly working hours decreased from 36,3 hours (SD = 10,5) before mTBI to 17,6 hours (SD = 9,7). Employees had difficulties with tasks 43% of time (WRFQ). They needed more breaks, struggled with multitasking and work speed. About 65.9% experienced affected work productivity. Managers reported lack of knowledge and difficulties assessing the number of working hours and suitable tasks. Conclusions Most employees returned to work but only a minority worked under similar conditions as before mTBI. Employees and managers struggled to estimate workload. The affected employees and their workplaces need a long-term RTW support.

© Conradsen I; Bang-Hansen VE; Sorensen AN; Rytter HM. Brain Injury. 1-10,

Purpose To describe long-term effects on activity, participation, and quality of life (i) at different post-injury starting time points of attention training and (ii) of two different types of rehabilitation with attention training in patients after stroke or traumatic brain injury; and to describe their functioning level. Methods Design: 2 years after rehabilitation intervention, comparisons were made in one cohort receiving attention training subacute (< 4 months) or post-acute (4-12 months) and in one cohort with two different training methods, a process-based and an activity-based method respectively. Patients: 100 patients were recruited from our earlier RCT study. They had mild to moderate stroke or traumatic brain injury with relatively limited symptomatology, and all had moderate to severe attention impairment. Data collection: A questionnaire-based interview: EuroQol 5 dimensions, Occupational Gaps Questionnaire, Work Ability Index, self-assessed work status, self-reported employment conditions, sick leave, and experienced cognitive limitations in work performance. Results An advantage for patients receiving subacute attention training regarding daily activities, work ability and returning to work. Conclusion The results indicate that subacute rehabilitation with attention training (< 4 months) is preferable compared to post-acute intervention (4-12 months). There were only minor differences between the training methods.

© Markovic G; Bartfai A; Schult ML; Ekholm J. Journal of Rehabilitation Medicine. 56:jrm5308, 2024 Jan 12.