Article

OBJECTIVE: To investigate predictors of return to work (RTW) in a poststroke
sample. DESIGN: Retrospective investigation of archival data from an inception
cohort; acute care records and 6-month follow-up telephone interview data were
obtained for analysis. SETTING: The Brain Recovery Core, a collaborative
interinstitutional endeavor among an academic medical center, an acute care
hospital, and a rehabilitation center. PARTICIPANTS: Data from patients with
stroke from the Brain Recovery Core (N=298). Excluded cases included those with
nontraditional and/or nonpaid job status, no National Institute of Health Stroke
Scale (NIHSS) score, and an NIHSS score >16. Our final sample included 244
individuals (age range, 25-87y). INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: Sociodemographic variables, stroke severity (NIHSS), and physical and
neurocognitive measures. RESULTS: Adding predictor variables to our logistic
regression model increased accuracy by approximately 18%. Greater independence in
the FIM sit-to-stand movement predicted improved RTW rates (odds ratio [OR], 1.8;
95% confidence interval [CI], 1.0-3.1), whereas nonwhite race (OR, 2.52; 95% CI,
1.16-5.47) and greater impairment on the NIHSS (OR, .88; 95% CI, .77-.99)
predicted attenuated RTW rates. CONCLUSIONS: Valid measures of stroke severity
and a clinician-rated sit-to-stand movement have utility in the acute prediction
of later RTW in patients with mild to moderate stroke. Given the complexity of
the RTW construct and the acute measurement of these variables, we believe that
our findings can be used to inform clinical decisions and appropriately tailor
rehabilitative strategies that improve quality of life for stroke survivors.
CI - Copyright A(c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS