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Return to work after mild-to-moderate stroke: work satisfaction and predictive factors
A large proportion of stroke patients are unable to return to work (RTW), although figures vary greatly. A total of 121 mild-to-moderate stroke patients, who had a paid job at the time of their stroke were included (a) to quantify RTW and work satisfaction one-year post-stroke (using the Utrecht Scale for Evaluation of Rehabilitation-Participation) and (b) to determine factors predicting RTW post-stroke, based on stroke-related, personal and neuropsychological variables. Half of the patients were not in work (28%) or were working less (22%) than pre-stroke. Ninety percent of those in fulltime employment...
Prognostic factors of return to work after traumatic or non-traumatic acquired brain injury
PURPOSE: To investigate and to determine evidence of prognostic factors for return to work (RTW) after acquired brain injury (ABI). METHOD: A systematic literature search was conducted in PubMed (2008-2014), applying terms for ABI and RTW. In addition, studies published after 2003 of a previous review on the same topic were added. The methodological quality of the included studies was assessed and evidence was classified. RESULTS: Twenty-seven studies were included. There is strong evidence that a high education level is positively associated with RTW after traumatic ABI; a low education level...
Stability of Employment Over the First 3 Years Following Traumatic Brain Injury
Objective: To examine the stability of employment between 1 and 3 years following traumatic brain injury (TBI) and to identify the variables associated with continued employment throughout this time span. Participants: This study included 236 individuals with predominantly moderate to very severe TBI, who had received rehabilitation in the context of a no-fault accident compensation system. Participants were eligible for the current study if they were employed before injury and reported their employment status at 1, 2, and 3 years following their injury as part of a longitudinal head injury outcome...
The Effect of Occupation-based Cognitive Rehabilitation for Traumatic Brain Injury
A Meta-analysis of Randomized Controlled Trials Traumatic brain injury (TBI) is the leading cause of death and disability among people younger than 35 years in the United States. Cognitive difficulty is a common consequence of TBI. To address cognitive deficits of patients with TBI, various cognitive rehabilitation approaches have been used for the clinical setting. The purpose of this study was to investigate the overall effect of occupation-based cognitive rehabilitation on patients' improvement in cognitive performance components, activity of daily living (ADL) performance, and values, beliefs...
Return-to-work in patients with acquired brain injury and psychiatric disorders as a comorbidity
A systematic review OBJECTIVE: To explore the association between psychiatric disorders as a comorbidity and return-to-work (RTW) in individuals with acquired brain injury (ABI). METHODS: A systematic review was performed. The search strategy (2002-2012) contained terms related to ABI, psychiatric comorbidity and keywords adapted to the outcome measure RTW. Selection and review were performed by two authors independently. In the case of uncertainty, a third author was consulted to reach consensus on inclusion or exclusion. The methodological quality of included studies was determined and evidence...
Functional and occupational characteristics predictive of a return to work within 18 months after stroke in Japan
Implications for rehabilitation Objective: This study examined clinical, functional, and occupational factors associated with return to work within 18 months after stroke, specifically focusing on the impact of higher cortical dysfunction on return to work in the chronic phase. Methods: This prospective cohort study in 21 hospitals specializing in clinical and occupational health recruited consecutive working-age inpatients receiving acute care for their first stroke (n = 351). A unified database was used to extract patient information from hospital records at the time of admission, discharge,...
The Effect of Vocational Rehabilitation on Return-to-Work Rates Post Stroke: A Systematic Review
Baldwin, Cathryn et Natasha K. Brusco (2011). The Effect of Vocational Rehabilitation on Return-to-Work Rates Post Stroke: A Systematic Review. Topics in Stroke Rehabilitation , 18(5): 562-572. Purpose: Returning to work has been identified as an important rehabilitation goal following stroke. Twenty percent of stroke survivors are of working age. The purpose of this systematic review was to determine the effect of vocational rehabilitation programs on return-to-work rates post stroke. Method: Searches were performed in electronic databases and Web-based sites. Studies were eligible for inclusion...
Functional and Occupational Characteristics Associated With Very Early Return to Work After Stroke in Japan
Tanaka H et al. (2011). Functional and occupational characteristics associated with very early return to work after stroke in Japan. Archives of Physical Medicine and Rehabilitation , 92 (5): 743-748. To examine clinical, functional, and occupational factors associated with very early return to work after stroke, and to identify factors manageable through occupational arrangements, patient education, and other welfare programs. Design: Prospective cohort study. Setting: Acute care of the first stroke event in 21 acute care hospitals specializing in clinical and occupational health. Participants...
Determining work outcomes in mild to moderate stroke survivors
Objective: To assess the work outcomes of individuals who have a mild to moderate stroke. Participants: Individuals who (1) experienced a mild to moderate stroke as determined by the National Institutes of Health Stroke Scale (NIHSS) scores (range 0–16); (2) were working full time prior to their stroke; and (3) were between the ages of 30–65. Methods: Participants were contacted and provided verbal consent to complete the Occupational Outcome Questionnaire (OOQ) over the telephone at 6 months post-stroke to determine their work outcomes. Results: Of the 98 participants recruited for...
Return to work after acquired brain injury: Facilitators and hindrances observed in a sub-acute rehabilitation setting
Objectives: There is great variability in the rate of return to work for persons who have suffered from brain injury. The aims of this study was: 1) to describe employment status of persons with stroke or traumatic brain injury, one year after the incident and 2) to investigate the impact of injury/stroke severity, length of stay, the ability to perform activities of daily living and cognitive function on return to work. Participants and Methods: Information was collected from 72 persons; 48 with a diagnosis of stroke and 24 with a traumatic brain injury. All patients had attended to a Rehabilitation...
Determinants of early return to work after first stroke in Japan
Objective: To examine the time to return to work after first stroke and identify determinants of early return to work in Japan. Design: A multicentre, prospective cohort study on the association between characteristics at admission and early return to work after first stroke. Subjects: Among 464 patients after first stroke, 325 were registered in this study. All participants were younger than 65 years and engaged in paid work at the time of the stroke. Methods: Data collected prospectively for 18 months were analysed using the Kaplan–Meier method for time trends, and then a multiple logistic...
Evaluation of evidence within occupational therapy in stroke rehabilitation
Evidence-based practice creates practice that integrates research-driven evidence with clinical expertise and patients' preferences in clinical decision-making. Aim: The aim of this study was to investigate and evaluate the quality and applicability of scientific research in occupational therapy intervention related to the use of everyday life occupations and client-centred practice within stroke rehabilitation. Design: Systematic searches of research studies published in English during 2000–2007 in peer-reviewed journals were undertaken. Thirty-nine articles and one Cochrane review were...
Young adults' experience of stroke: a qualitative review of the literature
Stroke is a life-threatening event that has a devastating impact on young adults and their families. The author conducted a systematic review of the qualitative literature to explore the experience of stroke from the perspective of young adults. Four primary research 'papers' were analyzed using the Qualitative Assessment and Review Instrument; 60 findings were extracted from the papers and merged into 13 categories, from which three synthesized findings were developed - disorientation, disrupted sense of self, and roles and relationships. Many of the effects of stroke are 'invisible'...
A community-based exercise and education scheme for stroke survivors: a randomized controlled trial and economic evaluation
Objective: The evaluation of a community-based exercise and education scheme for stroke survivors. Design: A single blind parallel group randomized controlled trial. Setting: Leisure and community centres in the south-west of England. Subjects: Stroke survivors (median (IQR) time post stroke 10.3 (5.4—17.1) months). 243 participants were randomized to standard care (124) or the intervention (119). Intervention: Exercise and education schemes held twice weekly for eight weeks, facilitated by volunteers and qualified exercise instructors (supported by a physiotherapist), each with nine participants...
Meeting stroke survivors’ perceived needs: a qualitative study of a community-based exercise and education scheme
Objective: A qualitative study using a phenomenological approach, to explore stroke survivors’ needs and their perceptions of whether a community stroke scheme met these needs. Methods: Semi-structured in-depth interviews of 12 stroke survivors, purposively selected from participants attending a new community stroke scheme. Interpretative phenomenological analysis of interviews by two researchers independently. Results: Participants attending the community stroke scheme sought to reconstruct their lives in the aftermath of their stroke. To enable this they needed internal resources of confidence...
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