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Return to Work Following Mild Traumatic Brain Injury

Wäljas, Minna PsyLic; Iverson, Grant L. PhD; Lange, Rael T. PhD; Liimatainen, Suvi MD, PhD; Hartikainen, Kaisa M. MD, PhD; Dastidar, Prasun MD, PhD; Soimakallio, Seppo MD, PhD; Öhman, Juha MD, PhD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP; Brenner, Lisa PhD, ABPP

Journal of Head Trauma Rehabilitation: September/October 2014 - Volume 29 - Issue 5 - p 443–450
doi: 10.1097/HTR.0000000000000002
Original Articles

Objective: To examine factors relating to return to work (RTW) following mild traumatic brain injury (mTBI).

Participants: One hundred and nine patients (Age: M = 37.4 years, SD = 13.2; 52.3% women) who sustained an mTBI.

Design: Inception cohort design with questionnaires and neuropsychological testing completed approximately 3 to 4 weeks postinjury.

Setting: Emergency Department of Tampere University Hospital, Finland.

Main Outcome Measures: Self-report (postconcussion symptoms, depression, fatigue, and general health) and neurocognitive measures (attention and memory).

Results: The cumulative RTW rates were as follows: 1 week = 46.8%, 2 weeks = 59.6%, 3 weeks = 67.0%, 4 weeks = 70.6%, 2 months = 91.7%, and 1 year = 97.2%. Four variables were significant predictors of the number of days to RTW: age, multiple bodily injuries, intracranial abnormality at the day of injury, and fatigue ratings (all P < .001). The largest amount of variance accounted for by these variables in the prediction of RTW was at 30 days following injury (P < .001, R2 = 0.504). Participants who returned to work fewer than 30 days after injury (n = 82, 75.2%) versus more than 30 days (n = 27, 24.8%) did not differ on demographic or neuropsychological variables.

Conclusions: The vast majority of this cohort returned to work within 2 months. Predictors of slower RTW included age, multiple bodily injuries, intracranial abnormality at the day of injury, and fatigue.

Department of Neurosurgery, Tampere University Hospital, Tampere, Finland (Ms Wäljas and Dr Öhman); University of Tampere Medical School, Tampere, Finland (Ms Wäljas and Drs Hartikainen, Dastidar, Soimakallio, and Öhman); Department of Physical Medicine and Rehabilitation, Harvard Medical School, and Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts (Dr Iverson); Defense and Veterans Brain Injury Center, Bethesda, Maryland (Dr Lange); Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Lange); Department of Neurosciences and Rehabilitation and Emergency Department Acuta, Tampere University Hospital, Tampere, Finland (Dr Liimatainen); and Medical Imaging Centre of Pirkanmaa Hospital District, Finland (Drs Dastidar and Soimakallio).

Corresponding Author: Minna Wäljas, PsyLic, Tampere University Hospital, Department of Neurosurgery, PO Box 2000, FIN-3521 Tampere, Finland (

This research was funded by Competitive Research Funding of the Pirkanmaa Hospital District, Tampere University Hospital. This study was done as part of the first author's PhD thesis research program.

The authors thank Pasi Jolma (MD, PhD) for recruiting the patients.

This study was presented at the third Federal Interagency Conference on Traumatic Brain Injury, Washington, DC, June 13–15, 2011.

Dr Lange notes that the views expressed in this article are those of the authors and do not reflect the official policy of the Department of Defense or US Government.

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins