Impact of interventions on work outcomes after musculoskeletal road traffic injuries: a systematic review

Dr Charlotte Brakenridge1, Dr Elise Gane1, Dr Esther Smits1, Dr Nicole Andrews1,2, Associate Professor Venerina Johnston1

1Recover Injury Research Centre, The University Of Queensland, Brisbane, Australia, 2Occupational Therapy Department and The Professor Tess Cramond Multidisciplinary Pain Centre, The Royal Brisbane and Women’s Hospital, Brisbane, Australia

Background: Musculoskeletal injuries are the most common non-fatal injuries that result from road traffic crashes. Even though these injuries are often ‘mild’ in severity, they can still affect one’s work capacity or ability to return to work post-crash. This review explored whether there are effective interventions that can improve work-related outcomes after musculoskeletal road traffic injuries.

Methods: A systematic search of seven databases was conducted in August 2018. Studies were included if they involved adults with a musculoskeletal injury from a road traffic crash, evaluated an intervention, and reported on a work-related outcome (e.g., time to return to work, sick leave).

Results: The review identified 25 studies from 24 papers. Studies were predominantly conducted in Europe (n=19), with the remaining studies conducted in Australia (n=4) or Canada (n=2). Individuals with whiplash injuries or whiplash-associated disorders were the most targeted group (n=19); the remaining studies included participants with a range of musculoskeletal injuries (n=3), fracture (n=1), soft tissue neck injury (n=1), or neck sprain injury only (n=1). Many interventions were delivered by physiotherapists only (n=11) or by a team of clinicians including physiotherapists (n=4). Only seven out of 25 studies (28%) reported a statistically significant intervention effect for at least one work-related outcome (most commonly days to return to work, 3 studies). These studies were heterogeneous in intervention delivery (physiotherapist, occupational therapist, rehabilitation physician, emergency department clinician, pharmacist), in the target of the intervention (pain, disability, return to work), and length of follow up (14 weeks to 1 year).

Conclusions: The evidence to date indicates that many interventions in individuals with musculoskeletal road traffic injuries do not improve work outcomes. Future research should evaluate more targeted return-to-work interventions, in a range of musculoskeletal injuries from a road traffic crash, with longer-term follow-up and cost-effectiveness outcomes.


Dr Brakenridge has a background in health psychology and public health, and completed her PhD in workplace health promotion in 2018. She is currently a postdoctoral research fellow at the RECOVER Injury Research Centre, evaluating return to work and function for people who have sustained a road traffic injury.

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