Return to work after stroke. A follow-up study.
OBJECTIVE
Few studies have reported the longitudinal trend of return to work after stroke. The purpose of our study was to evaluate the longitudinal trend of proportion of patients who return to work after stroke and further to examine the predictors of return to work while taking follow-up periods into consideration.


METHODS
We conducted a retrospective cohort study on the association between characteristics of stroke patients at admission and return to work after first stroke, taking length of follow-up period into consideration (n = 183). The patients were all younger than 65 years and were working at the time of their stroke. A follow-up questionnaire evaluated return to work and related information. Data were analyzed using the Kaplan-Meier method for curves of the proportion of return to work and Cox's proportional hazards model for odds ratios of return to work.


RESULTS
The curve of proportion of return to work had two steep slopes, and the proportion was at a maximum at 18 months from patient admission. The adjusted odds ratios of return to work for patients with normal muscle strength versus severe weakness, without apraxia versus with apraxia, and with white-collar versus blue-collar occupations were 5.16 (P < .05), 4.16 (P < .05), and 1.43 (.05 < P < .10), respectively.


CONCLUSIONS
The increase of proportion of return to work after stroke was nonlinear, and this trend was referable to the social security systems available to the patients included in this study. Normal muscle strength and absence of apraxia were significant predictors of return to work after stroke. White-collar occupation showed a tendency to promote return to work.
Saeki
S
S
Department of Rehabilitation Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
Ogata
H
H
Okubo
T
T
Takahashi
K
K
Hoshuyama
T
T
D000293:Adolescent; D000328:Adult; D001072:Apraxias / Q000503:physiopathology; D002545:Brain Ischemia / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000503:physiopathology*; D015331:Cohort Studies; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology; D009790:Occupations; D016017:Odds Ratio; D010343:Patient Admission; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012943:Social Security