Outcomes of return-to-work after stroke rehabilitation: A systematic review

You wouldn't need this type of research if we had protocols to stop the neuronal cascade of death and standard rehab protocols to bring back damaged functions. A lot more people would get close to 100% recovery. Focus on the correct problem, not the secondary problems. All this is due to NO stroke leadership or strategy.

Outcomes of return-to-work after stroke rehabilitation: A systematic review

1. Xi-Jun Wei1
2. Xue-feng Liu2
3. Kenneth NK Fong3⇑

1. ¹PhD Candidate, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR
2. ²Lecturer, School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
3. ³Associate Professor, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR

1. Kenneth NK Fong, Occupational Therapy Programme, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR. Email: rsnkfong@polyu.edu.hk

Abstract

Introduction The purpose of this systematic review was to identify the outcomes of return-to-work for stroke survivors of working age after conventional stroke rehabilitation or vocational rehabilitation.

Method Searches were performed using three electronic databases for literature published in English in the 10-year period 2004–2014 which included a population of working age stroke survivors who had previously participated in conventional or vocational rehabilitation, and which presented the outcomes of return-to-work.

Findings The literature search yielded 10 studies that satisfied our selection criteria. Three studies involved vocational rehabilitation. Studies illustrated and compared the vocational status at or among different stages of ‘pre-stroke’, ‘post-stroke and before rehabilitation discharge’, ‘rehabilitation discharge’ and ‘follow-up’. The employment rate at follow-up ranged from 7% to 81.1%.

Conclusion Methodological variations accounted for the wide range of return-to-work rates. There was limited evidence to support the conclusion that rehabilitation increases return-to-work rates for stroke survivors of working age, but recent studies showed that improvements in fatigue and cognitive function after stroke rehabilitation were related to good return-to-work outcomes. Either specialised vocational rehabilitation, conventional stroke rehabilitation or their combination is needed to increase return-to-work rates and improve the quality of life for stroke survivors of working age.