September 22, 2017 / 4:47 PM / 2 years ago

Intensive rehab can help military patients work after brain injuries

(Reuters Health) - Four in five military service members who suffer brain injuries may be able to return to military or civilian work after they get treatment at inpatient rehabilitation facilities, a UK study suggests.

Almost one-third of these service members can return to a full-time military job after intensive rehab, the study also found.

The results suggest that the costs of treatment in residential rehabilitation programs can pay off in the long run, said Lieutenant Colonel Dr. Markus Besemann, a chief of rehabilitation medicine for the Canadian Forces Health Services and a lecturer at the University of Ottawa.

“We know that the rates for returning to sustained work are generally poor for both military service members and civilians for a number of reasons,” Besemann, who wasn’t involved in the study, said by email.

“The results of this study are encouraging in that a substantial proportion of military personnel were able to return to military-specific function with appropriate intensive rehabilitation,” Besemann added. “Although the costs of such programs are substantial, the investment pays dividends when factored out over the lifetime of the individual who is able to re-integrate the same or an alternate vocation.”

For the study, Dr. Sardar Bahadur of the Defense Medical Rehabilitation Center Headley Court in Surrey, UK, and colleagues examined survey data on employment for military patients discharged from inpatient rehab programs for brain injuries between 2012 and 2014. Dr. Bahadur didn’t respond to requests for comment.

During the study period, an average of 57 patients were discharged from rehab each year. Researchers were able to contact just under half of these former patients.

Overall, 81 percent of the study participants were either working or in job training two to three years after leaving rehab, the study team reports in the Journal of the Royal Army Medical Corps.

Thirty-two percent of them returned to full-time jobs in the military within this time frame, and 40 percent had civilian jobs.

The severity of brain injuries didn’t appear to significantly influence the odds of employment, the study also found.

Two things did appear to increase the odds of a successful return to work after brain injuries: trial placements in jobs to make sure the work is a good fit for the employee and programs that allow for gradual re-entry into the workforce instead of a full-time role right after rehab.

Beyond its small size, other limitations of the study include the lack of data beyond three years, which makes it difficult to say whether service members might have a full military career or long-term success in the civilian workforce.

In addition, it’s possible that people with less successful employment prospects after their brain injuries might have declined to participate in the survey.

“We know that most service members with concussion do return to work in the short-term but longer term many have PTSD or other mental health conditions and these have the potential to worsen after discharge from the military,” said Dr. Jack Tsao, a researcher at the University of Tennessee Health Science Center in Memphis and Memphis Veterans Affairs Medical Center who wasn’t involved in the study.

However, the potential for even people with severe brain injuries to return to work after inpatient rehabilitation should be encouraging to military and civilian patients alike, Tsao said by email.

“Severity of brain injury should not put people off from seeking the best brain injury rehabilitation care center to get rehabilitation and therapies,” Tsao said.

SOURCE: Journal of the Royal Army Medical Corps, online August 9, 2017.

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