The relative importance of work-related factors on return to work in adults with persistent postconcussion symptoms - A cohort study.

BackgroundPersistent post-concussion symptoms hinder return to work, yet the relative importance of specific workplace accommodations supporting this process remains unclear.ObjectiveTo investigate the relative importance of influential work related factors on the Return to Work (RTW) process in persons with persistent postconcussion symptoms (PPCS).MethodsA longitudinal survey study of employees with PPCS (n = 63) and their employers (n = 63) regarding different work accommodations to support RTW. Accommodations were: working from home, having a written plan for RTW, utilizing work aids, implementing a gradual return, and adapted tasks. Outcomes were RTW in any capacity, RTW under similar work conditions as before mild traumatic brain injury, and sick-leave. The impact of work accommodations on outcome measures was examined by a dominance analysis considering sociodemographic factors, work-related factors and symptom burden. Logistic regression analysis was applied to examine the direction of effects.ResultsThe most influential factor on RTW in any capacity and sick-leave was the possibility of consistently working from home (30%). The most influential factor on RTW under the same conditions was having a written plan for RTW (27%). Regression analysis showed that the interventions had the greatest impact if they were applied consistently over time whereas inconsistent possibility of working from home had a negative impact on RTW.ConclusionsThe findings indicate that two of the most influential factors for RTW in the context of PPCS were long-term option of working from home and the presence of a written plan for the RTW process.