Access and adherence to the most recent recommendations regarding resumption of activities after a mild traumatic brain injury

ABSTRACT

Objectives

1) To examine access and adherence to the Berlin (2016) recommendations for resuming physical and intellectual activities after mild traumatic brain injury (mTBI) (including an exploration of barriers and facilitators). 2) To assess post-mTBI symptoms in relation to recommendation adherence.

Method

73 participants who sustained a mTBI completed an online survey with questions about access and adherence to recommendations and validated measures of symptoms.

Results

Almost all participants had received recommendations from a health professional after their mTBI. Two thirds of recommendations reported had at least moderate correspondence with the Berlin (2016) recommendations. The vast majority of participants reported weak or partial adherence to these recommendations and only 15.7% reported complete adherence. Overall, adherence to recommendations explained a significant portion of the variance in the severity and number of unresolved post-mTBI symptoms. The most common barriers were: being in a critical period for school or work, pressure to return to work or school, screen use, and presence of symptoms.

Conclusions

Sustained efforts are required to disseminate appropriate recommendations after mTBI. Clinicians should support patients in eliminating barriers to recommendation adherence, as greater adherence may facilitate recovery.

KEYWORDS:

• Mild traumatic brain injury
• concussion
• return to activity
• recommendations
• adherence

Acknowledgments

The authors would like to thank all participants.

Disclosure statement

The authors declare that there are no conflicts of interest. The authors report no disclosures relevant to the manuscript.

Author contributions

Concept and design: SEPL, MCO, CG, SBB. Acquisition, analysis, or interpretation of data: SEPL, MCO, KC. Drafting of the manuscript: SEPL, MCO. Critical revision of the manuscript for important intellectual content: all authors.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author, MCO. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

Additional information

Funding

This study was funded with the senior authors’ institutional funds (Université Laval).