[Abstract] Work limitations four years following mild traumatic brain injury: A Cohort Study



To explore employment status, work limitations and productivity loss following mild traumatic brain injury (TBI).

Study Design

Inception cohort study over four years.


General community.


245 Adults (>16 years at the time of injury), who experienced a mild TBI and who were employed prior to their injury.


Not applicable

Main Outcome Measures

Details of the injury, demographic information and pre-injury employment status were collected from medical records and self-report. Symptoms and mood were assessed one-month post-injury using the Rivermead Post-Concussion Symptom Questionnaire and the Hospital Anxiety and Depression Scale. Post-injury employment status and work productivity were assessed four-years post-injury using the Work Limitations Questionnaire.


Four-years following mild TBI, 17.3% of participants had exited the workforce (other than for reasons of retirement or to study) or had reduced their working hours compared to pre-injury. A further 15.5% reported experiencing limitations at work as a result of their injury. Average work productivity loss was 3.6% The symptom of ‘taking longer to think’ one month post-injury significantly predicted work productivity loss four years later (β = 0.47, t = 3.79, p = <0.001).


Whilst changes in employment status and difficulties at work are likely over time, the results indicate increased unemployment rates, work limitations and productivity loss in the longer-term following a mild TBI. Identification of cognitive difficulties one month following TBI in working aged adults and subsequent interventions to address these difficulties are required to facilitate work productivity.

Source: Work limitations four years following mild traumatic brain injury: A Cohort Study – Archives of Physical Medicine and Rehabilitation


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