Traumatic Brain Injury (TBI): Transformed By Injury Occupational Therapy's Role in Return to work following a TBI

Document Type


Publication Date



Faculty Mentor:

Teal Benevides PhD, MS, OTR/L; Department of Occupational Therapy, Thomas Jefferson University


Objectives of Presentation:

1. Recognize the association between a traumatic brain injury (TBI) and three ways that it impacts return to work.

2. Summarize the systematic review process of appraising the literature.

3. Describe the evidence that supports occupational therapy’s role in treating individuals with TBI and return to work.

4. Explain two ways to integrate the current evidence into occupational therapy practice for individuals with TBI in return to work interventions.


What is the evidence supporting the use of occupational therapy interventions for improving return to work in individuals with TBI?


Databases Used: CINAHL – 137 articles, Ovid SP (Medline & non-indexed) - 127, Cochrane (all databases) -446 Total: 710. Following screening a total number of 11 articles met inclusion/exclusion criteria. All articles critiqued using the Law and MacDermid Checklist 11, the Modified PRISMA checklist 13, Credential Check 4, or the Critical Appraisal Checklist modified from Critical Appraisal Skills Programme 7


Cognitive Interventions n=5 There is limited evidence to support the use of compensatory and remedial strategies 1

Level I: no significant difference in RTW outcomes in with cognitive interventions versus control 23 2

Level V: supported the use of cognitive interventions in RTW3, 10, 12

Environmental Interventions n=6

Employer involvement: There is insufficient evidence to support the use of employer involvement in RTW interventions 1 Case Study and 1 Expert Opinion: Employer involvement was effective in RTW outcomes 3, 12

Onsite interventions: There is limited evidence to support the use of onsite interventions for RTW 4 Level 5: 1 Case Study demonstrated increased competency in RTW3, 1Expert Opinion supported use of onsite interventions 12, 3 Literature review demonstrated increased RTW and sustained work 10, 18

Workspace modifications: There is insufficient evidence to support the use of workspace for RTW outcomes 1 Case Study and 1 Expert Opinion: Workspace modifications were effective in RTW outcomes 3, 12

Psychosocial factors n= 6

Self Efficacy: Self-perceived level of competency and self-esteem were identified as factors to RTW. 3, 20, 21, 22

Acceptance: Level of insight and acceptance of abilities and limitations were identified as factors for successful RTW. 2, 21

Social Support: Family support 2, 14, 20, 21, Community support 20, Support within work environment 2, 9, 20, 21

Occupational Identity: Participation in previous roles and occupational routine, balance of occupations 20, 22

Presentation: 45 minutes

Conklin et al (2015) TBI-Transformed by Injury.pdf (32 kB)
Handout with results and references