Impact of Upper Limb Function and Employment Status on Return to Work of Blue-Collar Workers after Stroke

Fukuda, Seisuke; Ueba, Yusuke; Fukuda, Hitoshi; Kangawa, Takumi; Nakashima, Yoshihiro; Hashimoto, Yasuko; Ueba, Tetsuya

doi:10.1016/j.jstrokecerebrovasdis.2019.04.036

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…Fifty-one primary research studies addressing factors influencing return to work were included 16,18–20,56–59,72–114 . Seven of these studies were specific to subarachnoid hemorrhage 72–78 .…”

Section: Resultsmentioning

confidence: 99%

Return to work for adults following stroke: a scoping review of interventions, factors, barriers, and facilitators

Coutts

Cooper

2023

JBI Evidence Synthesis

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Introduction: Difficulties in returning to work can significantly impact individuals following a stroke (eg, their sense of purpose and self-esteem), not only financially, but also as they adjust to the change in their situation. Such difficulties may arise from communication disorders as well as physical impairments. Previous reviews on return to work post-stroke have focused on specific aspects, such as interventions, or barriers and facilitators, but have not provided a comprehensive map of the field. Further, no systematic or scoping reviews to date have focused on literature addressing return to work for people with communication disorders post-stroke.Inclusion criteria: This review considered literature that reported on interventions, barriers, and facilitators for return to work for adults (aged 16 years or older) following an ischemic or hemorrhagic stroke. Records focusing on transient ischemic attacks or acquired brain injury were excluded, as were those in which a comorbidity or disability (eg, learning disability, dementia, respiratory disorder) had a significant impact on the individual's ability to work. Methods: This review followed the JBI scoping review methodology. Primary research of any type, systematic and non-systematic reviews, and gray literature from developed countries written in English from 2010 to the present day were identified from 7 databases, 2 gray literature repositories, JBI Evidence Synthesis, and an internet search. Records were screened for relevance to the review topic by 2 independent reviewers, and data relevant to the review questions were extracted. Findings were presented as narrative supported by tables.Results: Of the 106 sources included, 61 addressed demographic-based, socioeconomic-based, impairment-based, or recovery-based factors related to return to work. One of these 61 sources, a narrative review, focused on communication disorders. Thirty-eight sources explored barriers and facilitators for return to work from different stakeholders' perspectives; 3 of these 38 sources, including 2 qualitative studies and 1 narrative review, focused on post-stroke communication disorders. Eleven sources focused on interventions, including 7 studies (reported across 9 sources) that developed or tested return-to-work interventions. Of these primary studies, 1 randomized controlled trial and 1 retrospective cohort study were identified. The remaining intervention studies were case studies or case series. None of these intervention studies addressed communication disorders.Conclusions: While there has been extensive research on factors, barriers, and facilitators for return to work poststroke, there is a lack of research on interventions supporting return to work. There is also a significant gap in the evidence base on returning to work with a post-stroke communication disorder, highlighting the need for further research in this important area.

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Section: Resultsmentioning

confidence: 99%

Return to work for adults following stroke: a scoping review of interventions, factors, barriers, and facilitators

Coutts

Cooper

2023

JBI Evidence Synthesis

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“…In einer eigens hierzu durchgeführten Literaturrecherche konnten nur drei Studien mit dreistelligen Stichprobenumfängen und nur sechs Längsschnittuntersuchungen identifiziert werden. Diesen Studien folgend werden die Funktionsfähigkeit [25], kognitive Funktionen [26], der Schweregrad der Erkrankung [27], jobbezogene Merkmale [28] sowie Alter und Geschlecht [25] als Prädiktoren für ein erfolgreiches RTW nach einer Rehabilitation aufgrund eines Schlaganfalls diskutiert.…”

Section: Introductionunclassified

Berufliche Teilhabe nach einer medizinischen Rehabilitation aufgrund neurologischer Erkrankungen

Streibelt

Zollmann

Rasch

et al. 2022

Rehabilitation (Stuttg)

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Zusammenfassung Ziel der Studie Für das deutsche Rehabilitationssystem existieren nur wenige repräsentative Erkenntnisse zur beruflichen Wiedereingliederung nach einer medizinischen Rehabilitation. Für Personen, die aufgrund einer neurologischen Erkrankung eine Rehabilitation in Trägerschaft der Deutschen Rentenversicherung (DRV) absolvierten, soll deshalb ermittelt werden, (a) welche sozialmedizinischen Risiken im Vorfeld der Rehabilitation bestehen, (b) wie gut die berufliche Teilhabe im Anschluss gelingt und (c) welche Informationen mit der beruflichen Teilhabe assoziiert sind. Methodik Die Fragen wurden anhand der Reha-Statistik-Datenbasis der DRV beantwortet. Eingeschlossen wurden Rehabilitand*innen, die in 2016 eine medizinische Rehabilitation aufgrund einer neurologischen Erkrankung abgeschlossen hatten. Die Analysen wurden für die Gesamtgruppe sowie differenziert nach den beiden Diagnosegruppen Zerebrovaskuläre Erkrankungen (ZE) und Multiple Sklerose (MS) durchgeführt. Berufliche Teilhabe wurde sowohl über eine monatliche Zustandsvariable bis 24 Monate nach der Rehabilitation als auch als Quote aller Personen, die nach 12 respektive 24 Monaten im Erhebungsmonat und den 3 vorhergehenden Monaten sozialversicherungspflichtig beschäftigt waren, operationalisiert. Für die Analyse der Einflussfaktoren auf stabile berufliche Teilhabe wurden multiple logistische Regressionsmodelle mit schrittweisem Einschluss, getrennt für die Quoten nach 12 und 24 Monaten, kalkuliert. Ergebnisse Insgesamt flossen 42.230 Datensätze in die Analyse ein (ZE: n=18.368, 44%; MS: n=6.343, 15%). Neurologische Rehabilitand*innen waren durchschnittlich 50 Jahre alt; 43% waren weiblich. Etwa 15% wiesen keine Fehlzeiten, 17% wenigstens sechs monatige Fehlzeiten im Jahr vor der Reha auf. Bei 31 bzw. 44% wurde eine psychische bzw. kardiologische Komorbidität dokumentiert. Rund 48% der Rehabilitand*innen mit ZE kehrte bis zwei Jahre nach der Rehabilitation in Arbeit zurück; bei MS-Rehabilitand*innen waren es 54%. Die stärksten Einflussfaktoren auf stabile berufliche Teilhabe waren die Fehlzeiten und das Entgelt vor Rehabilitation sowie die Arbeitsfähigkeit bei Aufnahme. Schlussfolgerung Etwa die Hälfte aller Personen mit neurologischen Erkrankungen kehrt nach einer medizinischen Rehabilitation in Deutschland wieder stabil zurück in Arbeit. Insbesondere die Arbeitsunfähigkeit sowie der Verdienst vor der Rehabilitation determinieren dies. Die Analyse stellt erstmals repräsentative Daten zur beruflichen Wiedereingliederung nach medizinischer Rehabilitation aufgrund einer neurologischen Erkrankung vor.

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“…This is especially true for younger patients who still have a prospect of returning to work, which is also interlinked with SES [ 17 ]. Hence, in particular, hand-arm motor function is a key factor for the performance of activities of daily living (ADLs) and returning to work [ 18 , 19 ]. In this context, the patient-centric view of their own recovery should not be neglected alongside objective measures of upper limb function.…”

Section: Introductionmentioning

confidence: 99%

Pre-stroke socioeconomic status predicts upper limb motor recovery after inpatient neurorehabilitation

et al. 2022

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Background Lower socioeconomic status (SES) is associated with higher mortality rates and the likelihood of receiving less evidence-based treatment after stroke. In contrast, little is known about the impact of SES on recovery after discharge from inpatient rehabilitation. The aim of this study was to investigate the influence of SES on long-term recovery after stroke. Patients and methods In a prospective, observational, multicentre study, inpatients were recruited towards the end of rehabilitation. The 12-month follow-up focussed on upper limb motor recovery, measured by the Fugl-Meyer score. A clinically relevant improvement of ≥5.25 points was considered recovery. Patient-centric measures such as the Patient-reported Outcomes Measurement Information System-Physical Health (PROMIS-10 PH) provided secondary outcomes. Information on schooling, vocational training, income and occupational status pre-stroke entered a multidimensional SES index. Multivariate logistic regression models calculating odds ratios (ORs) and corresponding confidence intervals (CIs) were applied. SES was added to an initial model including age, sex and baseline neurological deficit. Additional exploratory analyses examined the association between SES and outpatient treatment. Results One hundred and seventy-six patients were enrolled of whom 98 had SES and long-term recovery data. Model comparisons showed the SES-model superior to the initial model (Akaike information criterion (AIC): 123 vs. 120, Pseudo R 2 : 0.09 vs. 0.13). The likelihood of motor recovery (OR = 17.12, 95%CI = 1.31; 224.18) and PROMIS-10 PH improvement (OR = 20.76, 95%CI = 1.28; 337.11) were significantly increased with higher SES, along with more frequent use of outpatient therapy ( p = .02). Conclusions Higher pre-stroke SES is associated with better long-term recovery after discharge from rehabilitation. Understanding these factors can improve outpatient long-term stroke care and lead to better recovery. KEY MESSAGE Higher pre-stroke socioeconomic status (SES) is associated with better long-term recovery after discharge from rehabilitation both in terms of motor function and self-reported health status. Higher SES is associated with significantly higher utilization of outpatient therapies. Discharge management of rehabilitation clinics should identify and address socioeconomic factors in order to detect individual needs and to improve outpatient recovery. Article registration: clinicaltrials.gov NCT04119479.

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Impact of Upper Limb Function and Employment Status on Return to Work of Blue-Collar Workers after Stroke

Cited by 7 publications

References 20 publications

Return to work for adults following stroke: a scoping review of interventions, factors, barriers, and facilitators

Return to work for adults following stroke: a scoping review of interventions, factors, barriers, and facilitators

Berufliche Teilhabe nach einer medizinischen Rehabilitation aufgrund neurologischer Erkrankungen

Pre-stroke socioeconomic status predicts upper limb motor recovery after inpatient neurorehabilitation

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