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; adherence; concussion; recommendations; return to activity.