Interventions to help adults with concussion return to work: A systematic review.

Abstract

Objective: Clinicians require guidance to aid patients who are attempting to return to work (RTW) after concussion. This systematic review synthesizes the results of interventions to determine what types of interventions (ie, early education and intervention, psychological, rehabilitative, and interdisciplinary) are effective, what behavior change techniques (BCTs) are most frequently used, and which BCTs are most promising.

Literature survey: MEDLINE ALL, PsycINFO, and CINAHL databases were searched for literature published January 2000 to the end of December 2023.

Methodology: Peer-reviewed adult concussion intervention studies of any design with RTW measurements were included. A narrative review describes the effectiveness of intervention type. For BCTs, the frequency of BCTs used in experimental conditions is provided. In addition, promise ratios were calculated to establish which BCTs are most effective.

Synthesis: Psychotherapy, neuropsychological training, vestibular rehabilitation, vision rehabilitation, exercise, compensatory strategies, cognitive training, vocational support, and interpersonal training may be efficacious. The BCT information about health consequences was used frequently in experimental conditions. Effective BCTs provided instruction on how to perform the behavior, reduce negative emotions, and action planning; participants were also provided information about health consequences and encouraged to do problem solving.

Conclusions: The promising interventions and BCTs identified in this article may be considered by qualified practitioners when helping patients with concussion RTW (PROSPERO: CRD42022384151).