Return to productive activity after traumatic brain injury: Relationship with measures of disability, handicap, and community integration

Wagner AK, Hammond FM, Sasser HC, Wiercisiewski D. Return to productive activity after traumatic brain injury: relationship with measures of disability, handicap, and community integration. Arch Phys Med Rehabil 2002;83:107-14. Objectives: To identify which factors are associated with successful return to productive activity (RTPA) 1 year after hospitalization with traumatic brain injury (TBI) and to examine the relations between successful RTPA and other measures of impairment, disability, handicap, and integration into the community. Design: Prospective study with 1-year follow-up. Setting: Level I trauma center. Participants: One hundred five respondents from a cohort of 378 adults hospitalized with TBI admitted between September 1997 and May 1998. Interventions: Not applicable. Main Outcome Measures: Return to productive work 1 year after injury; Disability Rating Scale (DRS); and Community Integration Scale (CIQ). Results: Of the 105 participants, 72% achieved RTPA. Logistic regression showed an association between RPTA and the following factors: premorbid educational level, premorbid psychiatric history, violent mechanism of injury, discharge status after acute hospitalization, prior alcohol and drug use, and injury severity. Handicap and community integration at 1-year postinjury, as measured by subscales of the DRS and the CIQ, were also associated with RTPA. Conclusion: Premorbid and injury-related variables and measures of handicap and community integration were associated with RTPA at 1 year. To understand and effectively support vocational pursuits in the TBI population, future studies are needed to define further causality and origin of these relationships. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation