Although additional VR training was not superior to conventional therapy alone, this study demonstrates the feasibility of VR training in early stroke.

(1) Objective: The World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) classification is a unified framework for the description of health and health-related states. This study aimed to use the ICF framework to classify outcome measures used in follow-up studies of coronavirus outbreaks and make recommendations for future studies. (2) Methods: EMBASE, MEDLINE, CINAHL and PsycINFO were systematically searched for original studies assessing clinical outcomes in adult survivors of severe acute respiratory distress syndrome (SARS), middle east respiratory syndrome (MERS) and coronavirus disease-19 (COVID-19) after hospital discharge. Individual items of the identified outcome measures were linked to ICF second-level and third-level categories using ICF linking rules and categorized according to an ICF component. (3) Results: In total, 33 outcome measures were identified from 36 studies. Commonly used (a) ICF body function measures were Pulmonary Function Tests (PFT), Impact of event scale (IES-R) and Hospital Anxiety and Depression Scale (HADS); (b) ICF activity was 6-Minute Walking Distance (6MWD); (c) ICF participation measures included Short Form-36 (SF-36) and St George’s Respiratory Questionnaire (SGRQ). ICF environmental factors and personal factors were rarely measured. (4) Conclusions: We recommend future COVID-19 follow-up studies to use the ICF framework to select a combination of outcome measures that capture all the components for a better understanding of the impact on survivors and planning interventions to maximize functional return.

Importance: Return to work after stroke is an important rehabilitation outcome. Vocational rehabilitation may support people with stroke to return to work. Objective: To report the return-to-work rate of people with stroke who completed a local community-based vocational rehabilitation program and to describe the program’s impact on their community reintegration. Design: Retrospective database study. Setting: Community-based voluntary welfare organization. Participants: Fifty-eight men and women ages 21 to 55 yr, formally diagnosed with stroke, with no significant cognitive impairment, and fit to undergo rehabilitation. Intervention: A pilot community-based interdisciplinary vocational rehabilitation program implemented between 2014 and 2017. The program included physical rehabilitation, psychosocial support, employment support, and caregiver support services. Outcomes and Measures: Return-to-work rate and community reintegration as measured by the Community Integration Questionnaire (CIQ). Results: Fifty participants completed the program. Their median age was 44 yr, and most were male (n = 37; 74%). Forty-four participants (88%) returned to work after completing the program. Statistically significant differences (p < .001) were found between their CIQ scores at program enrollment and at completion. Conclusions and Relevance: The program appeared to benefit people with stroke in their return-to-work process. Future studies are recommended to determine the effectiveness of such programs and identify features contributing to their success. Potential implications for occupational therapy practice are that vocational rehabilitation interventions can be initiated earlier, comprehensive return-to-work programs can better address the unique needs of people with stroke, and interdisciplinary evaluations are needed to assess suitability for return to work. What This Article Adds: One of occupational therapy’s unique goals is to facilitate performance and participation in valued activities such as work. Occupational therapists can play a pivotal role across the continuum of care to support their clients to explore and achieve their vocational goals after stroke.

Objectives: To identify and describe the transition of latent profiles characterized by caregiver psychosocial health characteristics over a 12-month period, to determine if stroke rehabilitation use at 12-month post-stroke differed by profile transition patterns, and to investigate if the identified profiles at 3-month post-stroke influence the explanation of stroke rehabilitation use at 12-month post-stroke by stroke rehabilitation use at 3-month post-stroke, with covariates.Design: Latent profile transition analysis of caregiver psychosocial health with stroke rehabilitation use at 12-month post-stroke as outcome. Setting and Participants: 149 stroke patient-caregiver dyads from the Singapore Stroke Study.Methods: Cross-sectional latent profile analyses were conducted on caregiver psychosocial health indicators of burden, depression, health status, quality of relationship with patient, and social support. Changes in latent profile classification over three time points (baseline, 3-month, and 12-month post-stroke) were analysed using latent transition analysis. A transition model with stroke rehabilitation use at 12-month post-stroke as the outcome was tested after accounting for covariates.Results: Two distinct caregiver psychosocial health latent profiles were found across time: non-distressed and distressed. Most caregivers were classified as non-distressed and remained non-distressed over time. Distressed caregivers at baseline were 76% likely to become non-distressed at 12-month post-stroke. Regardless of profile transition patterns, non-distressed caregivers at 12-month post-stroke tended to have cared for stroke rehabilitation non-users at 12-month post-stroke. Patient depression explained profile classification at 3-month and 12-month post-stroke. After accounting for covariates, the association between stroke rehabilitation use at 3-month and 12-month post-stroke was present only when caregivers were non-distressed at 3-month post-stroke.Conclusions and Implications: With covariates, stroke rehabilitation use at 3-month positively predicted rehabilitation use at 12-month post-stroke only when caregivers were non-distressed at 3-month post-stroke. Early psychosocial health assessment and sustained support should be made available to stroke caregivers to enhance their well-being and subsequent patient rehabilitation participation.