Surveying the Landscape of Persistent Concussive Symptoms in Adults Through an Occupational Lens

Abstract

Abstract Importance: Little is known about how and to what extent persistent concussive symptoms affect occupational performance in adults. Objective: To evaluate the impact of persistent postconcussive symptoms on occupational performance. Design: A cross-sectional study design was used in which the occupational performance needs of adults with persistent concussion symptoms were identified by a trained occupational therapist via semistructured interview. Setting: University research space. Participants: Adults ages 18 to 60 yr experiencing persistent concussion symptoms. Outcomes and Measures: Occupational performance was evaluated using the Canadian Occupational Performance Measure. Data were then categorized by two researchers using the Occupational Therapy Practice Framework: Domain and Process (4th ed.). Results: The most commonly affected occupational performance areas included education and work, social participation, and performance of instrumental activities of daily living. Conclusions and Relevance: Aligning with prior knowledge of the impact of psychosocial difficulties and higher order cognitive deficits on daily life, performance of complex occupations is heavily affected in adults with persistent concussive symptoms. Plain-Language Summary: The functional impact of symptoms that adults experience postconcussion becomes apparent as they return to their life occupations. The results of this study showed that adults with persistent concussive symptoms more commonly experienced occupational challenges with participation in education, social activities, and the performance of instrumental activities of daily living, with subtle, important variations in symptoms across adults. Detailed, client-centered evaluation of occupational performance changes postconcussion is an area of potential growth for occupational therapy practice and research.