Abstract
Objective
To examine operational definitions of return to work (RTW) poststroke and provide
more precise estimates of RTW through meta-analysis.
Data Sources
A systematic search was conducted using MEDLINE, CINAHL, PsycINFO, and SCOPUS (2005
to March 26, 2018). The search strategy involved expansion of medical subjective headings
using terms related to stroke and work. The reference lists of review articles and included studies were checked for additional
relevant studies.
Study Selection
Studies were included if they (1) quantitatively analyzed RTW outcomes or factors
associated with RTW; (2) reported RTW outcomes for participants employed prior to
stroke; and (3) were written in English or French. Two reviewers independently screened
titles and abstracts. Of 7265 articles initially identified, 55 studies were included.
Data Extraction
Data were extracted and study quality was assessed by 1 reviewer and verified by a
second reviewer.
Data Synthesis
Explicit and implicit operational definitions of RTW were determined and categorized.
Ranges of RTW estimates were presented for study and participant characteristics.
Pooled summary estimates were calculated for comparable studies by follow-up time
poststroke: 55.7% at 1 year (95% confidence interval [95% CI], 51.3%-60.0%) and 67.4%
at 2 years (95% CI, 60.4%-74.4%). Similar summary estimates were noted when only population-based
studies were considered: 56.7% at 1 year (95% CI, 48.3%-65.1%) and 66.7% at 2 years
(95% CI, 60.2%-73.2%).
Conclusions
Operational definitions varied across studies and were often not explicitly reported.
To promote comparability of RTW outcomes in future studies, we recommend working toward
a universal operational definition and consistent follow-up times. The more precise
estimates calculated in this review could be used as benchmarks for health care and
social service providers.
Keywords
List of abbreviations:
CI (confidence interval), RTW (return to work)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 24, 2018
Footnotes
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
