Characteristics of Stroke Survivors Treated in an Interdisciplinary Outpatient Rehabilitation Program Who Return to Work

Background: Return to Employment and driving are goals for many stroke survivors. Little is known about the frequency and characteristics of patients returning to work. Methods: Prospective observational study of stroke patients treated between 12/2011-1/2015 in an interdisciplinary outpatient rehabilitation program that addresses physical, psychosocial, cognitive, communicative, risk factors, driving, and vocational issues. Results: Of 96 consecutive patients, 48% were working prior to their stroke. 44% (70% men, 30% women) of those working prior to their stroke returned to work upon program completion. On admit, these returning workers had an average age of 56 years, average NIHSS score of 3.4(range 0-9), 40% were aphasic, 65% needed assistance with ADL9s(55% with {mRS} of 3 and 10% with {mRS} of 4). 15 of these suffered ischemic strokes( 4 Left, 4 Right, 3 Bi-lateral hemisphere, 4 posterior circulation), and 5 had hemorrhages. All patients working prior to their stroke were also driving, and 15% of these were driving on admit. 90% of those who returned to work also returned to driving. In those returning to work, Stroke Impact Scale(SIS) scores improved an average of: mood 12%, ADL’s 15%, participation 24%, and stroke recovery domain 16%. These patients received an average of 21 physical therapy visits, with 6 minute walk and Berg Balance scores improving an average of 112% and 11% respectively. Multiple other demographic, risk factor, and outcome measures are collected. An additional 9% of patients were work capable on discharge. In comparison, 19 of those not returning to work had ischemic strokes, 7 had hemorrhages. This group had average age 57, average NIHSS score 6.8(range2-16), 42% aphasic, 89% needed assistance with ADL’s (58% with {mRS} of 3 and 31% with {mRS} of 4), and 28% returned to driving. Average length of stay was 4 (range 0.25-12) and 6 months(range 2-12) in those returning and not returning to work respectively. Conclusions: These findings demonstrate that outpatient rehab programs can promote stroke recovery, return to work and driving. Further collection of characteristics and rehabilitation outcomes of patients returning to work can help direct rehabilitation efforts for patients with return to work goals.