Article Text

Download PDFPDF

What characterises work and workplaces that retain their employees following acquired brain injury? Systematic review


Objectives The objective of this study was to conduct a systematic review assessing workplace factors related to work retention (or return to work) in employees with acquired brain injury (ABI). Additionally, we aimed to synthesise the evidence and state of knowledge on this subject.

Methods A database search was performed in nine relevant electronic databases. Inclusion criteria were quantitative peer-reviewed publications empirically investigating the relationship between work/workplace factors and work retention in employees following ABI. The methodological quality was determined by Effective Public Health Practice Project scoring, and evidence was synthesised narratively.

Results Thirteen studies were included. We found moderate evidence for a negative relationship between manual work and work retention. We also found limited evidence for a U-shaped relationship between workload and complete work retention at 6 months and no relationship at 12 months; a positive relationship between managers, compared with non-managers, and faster work retention; a positive relationship between large enterprise size defined as ≥250 employees, and no relationship between large enterprise size, defined as ≥1000 employees, and work retention.

Conclusion Relative to individual factors, there is little evidence on specific workplace factors’ relationship to work retention among employees with ABI. For most workplace factors, there were too few high-quality studies to designate evidence as more than limited or insufficient. Future studies should replicate rigorous studies of well-defined modifiable workplace factors related to work retention.

PROSPERO registration number CRD42018082201.

  • return to work
  • workplace
  • stroke
  • work retention
  • brain injury

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Twitter @wendy_nilsen

  • Collaborators Vilde Hoff Bernstrøm, Pål Klethagen, Bettina Grødem Knutsen, Malene Wølch Gundersen and Ingjerd Legreid Ødemark.

  • Contributors Study concept and design: DEA, WN, VHB, ØS, HE, NA and ML. Screening: DEA, ØS, LF, PK, HE, NA, EIH, ML and VHB. Quality assessment: DEA, SCRF, WN, EIH, LF, NA, ML, HE and ØS. Literature search: BGK, MWG and ILO. Evidence synthesis: DEA, WN and ML. Funding applications: NA, ØS, HE and ML. Drafting of the manuscript: DEA, WN, EIH, SCRF, NA, ML, HE, ØSand LF. Critical revision of the manuscript for important intellectual content: all authors. DEA: guarantor.

  • Funding This research was partly funded by the Research Council of Norway (grant 256 689); the Work Research Institute, OsloMet–Oslo Metropolitan University; and the Department of Research, Sunnaas Rehabilitation Hospital.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.