ABSTRACT
Objective: To examine challenges in return to work (RTW) for persons with persistent postconcussion symptoms (PPCS) experienced by the affected employees and their managers.
Methods: A survey of employees (S-E) and two surveys of managers (S-M1, S-M2) executed 4 months apart to capture time perspective. Inclusion: Adults aged 18-66 with PPCS >4 weeks, employed at time of mTBI who returned to work within the previous year. Managers involved in their RTW process.
Outcome measures: Work status, working hours, work functioning (Work Role Functioning Questionnaire, WRFQ), work productivity.
Results: 92 employees and 66 managers were recruited. 3/4 of the employees had returned to work but only 1/3 worked under similar conditions. Weekly working hours decreased from 36,3 hours (SD=10,5) before mTBI to 17,6 hours (SD=9,7). Employees had difficulties with tasks 43% of time (WRFQ). They needed more breaks, struggled with multitasking and work speed. 65.9% experienced affected work productivity. Managers reported lack of knowledge and difficulties assessing the number of working hours and suitable tasks.

Conclusions: Most employees returned to work but only a minority worked under similar conditions as before mTBI. Employees and managers struggled to estimate workload. The affected employees and their workplaces need a long-term RTW support.