Interventions to Facilitate Return to Work after Stroke: A Systematic Review

To gather knowledge about effective return to work interventions for survivors of stroke.

A database search was conducted in MEDLINE, CINAHL, PsycINFO, Scopus, and Web of Science using keywords and medical subject headings. Studies were included if they met the following criteria: (i) studies published in English since the year 2000; (ii) adult patients aged 18-65 with a primary diagnosis of stroke; (iii) working pre-stroke; and (iv) intervention in which one of the primary outcomes is return to work. The methodological quality of included studies was assessed and the evidence synthesised.

Twelve studies were included, of which three were randomised controlled trials, four were retrospective studies, one was a cohort study, one was an explorative longitudinal study, one was a pre-post treatment observation study and two were pilot studies. The employment rate at follow-up ranged from 7% to 75.6%. Overall, there was limited published evidence regarding the effectiveness of interventions to promote return to work for this population, and it was unclear if return to pre-stroke work was the goal.

A lack of large, controlled trials, variations in follow-up time and the definitions of return to work accounted for the large range of employment rates at follow-up. There is limited published high-quality evidence regarding the effectiveness of interventions to promote return to work in working-age survivors of stroke.