Return to Work after Stroke: Recording, Measuring, and Describing Occupational Therapy Intervention

Grant, Mary; Radford, Kathryn; Sinclair, Emma; Walker, Marion F

doi:10.4276/030802214x14098207541072

Cited by 24 publications

(29 citation statements)

References 20 publications

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“…This figure is significantly higher than similar civilian studies;16 however, our cohort exhibits significant differences, being younger, fitter and in employment pre-injury. Studies by Grant et al 6 and Waddell et al 7 have shown that RTW and ability to remain in employment should be used to evaluate success. A longer-term study to assess levels of sustained employment at 5 years after discharge is planned.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Getting soldiers with brain injury back to work: the defence medical rehabilitation centre neurological vocational pathway

Olivier¹,

Duncan-Anderson

Mitchell

et al. 2015

J R Army Med Corps

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The Neuro-Rehabilitation Group at the Defence Medical Rehabilitation Centre (DMRC) has developed an integrated vocational pathway to transition service personnel back into employment. This article describes how vocational rehabilitation at DMRC fits with the wider UK military, in comparison with civilian rehabilitation. It also describes the ongoing development of the vocational pathway, which contributes to improved outcomes from neurological disorders, including traumatic brain injury. We present two cases to highlight how the programme integrates with and influences patient care.

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Section: Discussionmentioning

confidence: 99%

“…Research surrounding VR and TBI survivors, in contrast, remains in its infancy. Studies to date can be described as being at a modelling or exploratory phase, where feasibility studies are being conducted,5 6 and no randomised controlled trial has yet been completed.…”

Section: The Need For Vrmentioning

confidence: 99%

Getting soldiers with brain injury back to work: the defence medical rehabilitation centre neurological vocational pathway

Olivier¹,

Duncan-Anderson

Mitchell

et al. 2015

J R Army Med Corps

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“…Retrospective description of work outcomes and metrics of stroke participants in a feasibility RCT of an early stroke VR intervention at 12 months post-stroke (trial reported elsewhere (29,30) Table I. The treating therapist provided information on work status, time to RTW and workplace accommodations for 3 intervention group participants who did not return outcome measures.…”

Section: Methodsmentioning

confidence: 99%

“…The aim of this study was to describe RTW after stroke, using the work metrics of stroke participants in a feasibility randomized controlled trial of an early stroke-specific VR intervention. Descriptions of the trial and content and dose of stroke-specific VR occupational therapy have been reported previously (29,30).…”

mentioning

confidence: 99%

What is a return to work after stroke? 12-month outcomes in a feasibility trial

Radford

Grant²,

Sinclair³

et al. 2020

J Rehabil Med

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Stroke is the single greatest cause of adult disability in the UK. A quarter of strokes affect people of working age; however, less than half of them return to work. This study described the nature of return to work and the help that people require to go back to work. A total of 46 participants were recruited from one English county. Participants were divided into 2 groups: a group receiving usual care and a group receiving extra rehabilitation. The study assessed their work status, the hours they worked, work accommodations, and what they earned at baseline, 3, 6 and 12 months after stroke. Most people returned to work after a mean of 90 days and stayed with the same employer. However, many people needed changes at work, worked fewer hours and earned less than they did before the stroke. Future research should investigate the implications of work adjustments for stroke survivors and whether the reported reductions in hours, status, roles and responsibilities are viewed as positive or negative. Objective: Stroke is the greatest cause of disability in adults. A quarter of strokes in the UK affect people of working age, yet under half of them return to work after stroke. There has been little investigation into what constitutes "return to work" following stroke. The aim of this study is to describe the work metrics of stroke survivor participants in a feasibility randomized controlled trial of an early stroke-specific vocational rehabilitation intervention. Methods: Retrospective analysis of trial data. Metrics on work status, working hours, workplace accommodations and costs were extracted from trial outcomes gathered by postal questionnaire at 3, 6, and 12 months' post-randomization for 46 stroke participants in a feasibility randomized controlled trial. Participants were randomized to receive vocational rehabilitation (intervention) or usual care (control). Results: Two-thirds (n = 29; 63%) of participants returned to work at some point in the 12 months following stroke. Participants took a mean of 90 days to return to work. Most returned to the same role with an existing employer. Only one-third of participants who were employed full-time at stroke onset were working full-time at 12 months post-stroke. Most participants experienced a reduction in pre-stroke earnings. Workplace accommodations were more common among intervention group participants. More intervention participants than control participants reported satisfaction with work at both 6 and 12 months post-randomization. Conclusion: This study illustrates the heterogeneous nature of return to work and the dramatic impact of stroke on work status, working hours and income. Longitudinal research should explore the socioeconomic legacy of stroke and include clear definitions of work and accurate measures of working hours and income from all sources.

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“…To describe the content of the intervention, a bespoke pro forma was designed to capture and record the visit content and actions undertaken by the occupational therapist. The pro forma was designed with reference to previous studies describing occupational therapists’ interventions within evaluative studies (Grant et al., 2014; Phillips et al., 2010). It covered the following areas: the length of time spent on the visit, the goals set and goals reviewed (achieved, partially achieved or not achieved), and any equipment or minor adaptations provided.…”

Section: Methodsmentioning

confidence: 99%

Content and acceptability of an Occupational Therapy intervention in HomEcare Re-ablement Services (OTHERS)

Whitehead

Drummond

Parry

et al. 2018

British Journal of Occupational Therapy

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Introduction: Despite clear compatibilities between the tenets of occupational therapy and re-ablement, there is limited research on occupational therapy in homecare reablement services. This paper describes the content of an occupational therapy intervention that was delivered in homecare re-ablement services as part of a feasibility randomised controlled trial (OTHERS). It also evaluates whether the intervention was acceptable to the participants who received it. Method: There were three phases. 1.) A bespoke pro forma was completed recording the activities undertaken after each therapy visit. 2.) An acceptability questionnaire was sent by post to every intervention participant. 3.) Semi-structured interviews were completed with key informants who received the intervention. Results/Findings: The principal activities undertaken were: assessment; case management; goal setting; advice and support; and practising activities. It was possible to implement a graded programme for participants' main goals in relation to bathing/showering or kitchen activities. Participants particularly valued the advice and support provided, however, there were difficulties due to fluctuations in circumstances and with activities of daily living (ADL) outside the home. Participants also had outdoor mobility goals but there were difficulties working on these within the 6-weeek timescale. Conclusion: An intervention focussing on ADL within the home was acceptable for participants and consistent with their goals and objectives; however, they also had goals beyond personal ADL and the timescale of the re-ablement episode which were not met. Further research should focus on extended ADL at a later stage beyond the time-limited period.

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Return to Work after Stroke: Recording, Measuring, and Describing Occupational Therapy Intervention

Cited by 24 publications

References 20 publications

Getting soldiers with brain injury back to work: the defence medical rehabilitation centre neurological vocational pathway

Getting soldiers with brain injury back to work: the defence medical rehabilitation centre neurological vocational pathway

What is a return to work after stroke? 12-month outcomes in a feasibility trial

Content and acceptability of an Occupational Therapy intervention in HomEcare Re-ablement Services (OTHERS)

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