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Zhang W, Ji H, Wang N, Sun K, Xu Z, Li J, Liu C, Sun Q, Wang C, Zhao F. The Needs and Experiences of Patients Returning to Work After Total Knee Arthroplasty and Total Hip Arthroplasty: A Systematic Review and Meta-Synthesis. Phys Ther 2024; 104:pzae024. [PMID: 38401168 DOI: 10.1093/ptj/pzae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/11/2023] [Accepted: 12/20/2023] [Indexed: 02/26/2024]
Abstract
OBJECTIVE The objective of this study was to conduct a systematic and comprehensive review of qualitative research to examine the physical and psychological needs, as well as work experiences, of patients undergoing total knee replacement and total hip replacement surgeries during their process of returning to work. METHODS A systematic review and meta-synthesis of qualitative literature was conducted. A systematic search was conducted across 8 databases to identify qualitative or mixed-methods research on the needs and experiences of individuals with total knee replacement and total hip replacement who have returned to work. The search period extended from the inception of each database to March 2023. Two researchers independently utilized a predetermined search strategy to retrieve relevant English-language studies published in any year. The included studies were assessed for quality using the Critical Appraisal Skills Program appraisal tool. Findings from the studies were then summarized and integrated using the pooled integration method. RESULTS There were 10 studies in total. Three key themes were identified from the original research: needs during the return to work process and rehabilitation training, faith and support to return to work, and constraints and challenges at work. CONCLUSION Health care professionals and employers should conscientiously consider the physical and psychological requirements of patients who have undergone total knee replacement and total hip replacement when they are resuming work, taking into account the specific constraints and challenges that may arise in the workplace. To ensure a seamless transition back to work, it is essential to develop tailored occupational interventions, implement comprehensive return to work programs, and offer patients sufficient understanding and support. IMPACT The findings of this study offer valuable insights into the physical and psychological needs, as well as the work experiences, of patients who have undergone total knee replacement and total hip replacement during their reintegration into the workforce. These findings have the potential to assist health care professionals and employers in providing enhanced support to facilitate successful return-to-work outcomes for patients.
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Affiliation(s)
- Wenzhong Zhang
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Hong Ji
- Nursing Department, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Ning Wang
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Kangming Sun
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Zhenzhen Xu
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Jing Li
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Cuihong Liu
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- Quality Control Department, Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Qingxiang Sun
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Chunlei Wang
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Fengyi Zhao
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
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Duong P, Egan M, Meyer M, Morrison T, Sauvé-Schenk K. The impact of stroke on employment income: A cohort study using hospital and income tax data in Ontario, Canada. Clin Rehabil 2024:2692155241249345. [PMID: 38689431 DOI: 10.1177/02692155241249345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To document the impact of stroke on employment income among people employed at the time of stroke. DESIGN Population-based cohort study. PARTICIPANTS People hospitalized for stroke in Ontario, Canada (2010-2014) and people without stroke matched on demographic characteristics. MAIN MEASURES Robust Poisson regression to estimate the effects of stroke on the probability of reporting employment income on tax returns over 3 years. Quantile regression difference-in-differences to estimate the changes in annual employment income attributable to stroke. RESULTS Stroke survivors were increasingly less likely to report any employment income poststroke, incidence rate ratios (IRR) 0.87 at 1 year (95% confidence intervals [CI]; 0.85-0.88), 0.82 at 2 years (95% CI; 0.81-0.84) and 0.81 at 3 years (95% CI; 0.79-0.82). IRR for reporting at least 50% of prestroke income levels were 0.76 at 1 year (95% CI; 0.75-0.78), 0.75 at 2 years (95% CI; 0.73-0.77) and 0.73 at 3 years (95% CI; 0.71-0.75). IRR for reporting at least 90% of prestroke income levels were 0.72 at 1 year (95% CI; 0.70-0.74), 0.66 at 2 years (95% CI; 0.64-0.68) and again 0.66 at 3 years (95% CI; 0.64-0.68). Relative changes in annual employment income attributable to stroke varied from a decrease of 13.8% (95% CI; 8.7-18.9) at the 75th income percentile to a decrease of 43.1% (95% CI; 18.7-67.6) at the 25th income percentile. CONCLUSIONS It is important for healthcare and service providers to recognize the impact of stroke on return to prestroke levels of employment income. Low-income stroke survivors experience a more drastic loss in employment income and may need additional social support.
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Affiliation(s)
- Patrick Duong
- Faculty of Health Sciences, Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Mary Egan
- Faculty of Health Sciences, Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Matthew Meyer
- Epidemiology and Biostatistics, University of Western Ontario, London, Canada
- Population Health, London Health Sciences Centre, London, Canada
| | - Tricia Morrison
- Faculty of Health Sciences, Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Katrine Sauvé-Schenk
- Faculty of Health Sciences, Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
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Li J, Pan X, Wang Z, Zhong W, Yao L, Xu L. Interventions to Support the Return to Work for Individuals with Stroke: A Systematic Review and Meta-analysis. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10178-y. [PMID: 38512392 DOI: 10.1007/s10926-024-10178-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE An increasing number of individuals with stroke are having difficulties in returning to work, having a significant impact on both individuals and society. The aims of this meta-analysis were to summarize the interventions to support the return to work (RTW) for individuals with stroke and to quantitatively evaluate the efficacy of each type of intervention. METHODS A systematic review and meta-analysis were conducted according to PRISMA guidelines. PubMed, Embase, Cochrane Library, CINAHL, and PsycINFO were searched until 26 June 2023, and the list of references of the initially included articles was also searched. Two researchers independently performed the search, screening, selection, and data extraction. The primary outcome was RTW rate (the RTW rate was defined as the proportion of individuals who returned to work in each group (intervention and control) at the endpoint). Pooled risk ratio (RR) was estimated using a random-effects model with 95% confidence intervals (CIs). RESULTS A total of 13 studies representing 4,282 individuals with stroke were included in our study. Results showed that physiological interventions could improve the RTW rate of individuals with stroke (RR: 1.19, 95% CI: 1.01 to 1.42, I2 = 72%). And receiving intravenous thrombolytic therapy was beneficial in promoting the RTW in individuals with stroke. Subgroup analysis and meta-regression analysis showed that the individuals' functional status during hospitalization was the only source of heterogeneity. Psychological interventions had little or no effect on the RTW rate of individuals with stroke (RR: 1.20, 95% CI: 0.58 to 2.51, I2 = 30%). Work-related interventions had little or no effect on the RTW rate of the individuals with stroke (RR:1.36,95%CI: 0.99 to 1.88, I2 = 73%). The subgroup analysis showed that country, age, and follow-up method were the sources of heterogeneity. CONCLUSION Physiological intervention promoted the RTW of individuals with stroke. But, the effect of psychological and work-related interventions in promoting the RTW of individuals with stroke was not significant. We anticipate that these findings may inform the design of future interventions. For future research, we recommend that more high-quality randomized controlled trials be conducted to further promote the RTW of individuals with stroke. SYSTEMATIC REVIEW REGISTRATION PROSPERO Registration Number, CRD42023443668.
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Affiliation(s)
- Jiaxuan Li
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xi Pan
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Zhi Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Weiying Zhong
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lin Yao
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lan Xu
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
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Coutts E, Cooper K. Return to work for adults following stroke: a scoping review of interventions, factors, barriers, and facilitators. JBI Evid Synth 2023; 21:1794-1837. [PMID: 37255032 DOI: 10.11124/jbies-22-00174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This scoping review aimed to map the literature on interventions, factors, barriers, and facilitators for return to work for adults post-stroke with or without communication disorders. INTRODUCTION Difficulties in returning to work can significantly impact individuals following a stroke (eg, their sense of purpose and self-esteem), not only financially, but also as they adjust to the change in their situation. Such difficulties may arise from communication disorders as well as physical impairments. Previous reviews on return to work post-stroke have focused on specific aspects, such as interventions, or barriers and facilitators, but have not provided a comprehensive map of the field. Further, no systematic or scoping reviews to date have focused on literature addressing return to work for people with communication disorders post-stroke. INCLUSION CRITERIA This review considered literature that reported on interventions, barriers, and facilitators for return to work for adults (aged 16 years or older) following an ischemic or hemorrhagic stroke. Records focusing on transient ischemic attacks or acquired brain injury were excluded, as were those in which a comorbidity or disability (eg, learning disability, dementia, respiratory disorder) had a significant impact on the individual's ability to work. METHODS This review followed the JBI scoping review methodology. Primary research of any type, systematic and non-systematic reviews, and gray literature from developed countries written in English from 2010 to the present day were identified from 7 databases, 2 gray literature repositories, JBI Evidence Synthesis , and an internet search. Records were screened for relevance to the review topic by 2 independent reviewers, and data relevant to the review questions were extracted. Findings were presented as narrative supported by tables. RESULTS Of the 106 sources included, 61 addressed demographic-based, socioeconomic-based, impairment-based, or recovery-based factors related to return to work. One of these 61 sources, a narrative review, focused on communication disorders. Thirty-eight sources explored barriers and facilitators for return to work from different stakeholders' perspectives; 3 of these 38 sources, including 2 qualitative studies and 1 narrative review, focused on post-stroke communication disorders. Eleven sources focused on interventions, including 7 studies (reported across 9 sources) that developed or tested return-to-work interventions. Of these primary studies, 1 randomized controlled trial and 1 retrospective cohort study were identified. The remaining intervention studies were case studies or case series. None of these intervention studies addressed communication disorders. CONCLUSIONS While there has been extensive research on factors, barriers, and facilitators for return to work post-stroke, there is a lack of research on interventions supporting return to work. There is also a significant gap in the evidence base on returning to work with a post-stroke communication disorder, highlighting the need for further research in this important area.
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Affiliation(s)
- Emma Coutts
- Speech and Language Therapy, NHS Grampian, Fraserburgh UK
| | - Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
- The Scottish Centre for Evidence-based, Multi-professional Practice: A JBI Centre of Excellence, Robert Gordon University, Aberdeen, UK
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Pearce G, O’Donnell J, Pimentel R, Blake E, Mackenzie L. Interventions to Facilitate Return to Work after Stroke: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6469. [PMID: 37569011 PMCID: PMC10418317 DOI: 10.3390/ijerph20156469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 08/13/2023]
Abstract
PURPOSE To gather knowledge about effective return to work interventions for survivors of stroke. METHODS A database search was conducted in MEDLINE, CINAHL, PsycINFO, Scopus, and Web of Science using keywords and medical subject headings. Studies were included if they met the following criteria: (i) studies published in English since the year 2000; (ii) adult patients aged 18-65 with a primary diagnosis of stroke; (iii) working pre-stroke; and (iv) intervention in which one of the primary outcomes is return to work. The methodological quality of included studies was assessed and the evidence synthesised. RESULTS Twelve studies were included, of which three were randomised controlled trials, four were retrospective studies, one was a cohort study, one was an explorative longitudinal study, one was a pre-post treatment observation study and two were pilot studies. The employment rate at follow-up ranged from 7% to 75.6%. Overall, there was limited published evidence regarding the effectiveness of interventions to promote return to work for this population, and it was unclear if return to pre-stroke work was the goal. CONCLUSION A lack of large, controlled trials, variations in follow-up time and the definitions of return to work accounted for the large range of employment rates at follow-up. There is limited published high-quality evidence regarding the effectiveness of interventions to promote return to work in working-age survivors of stroke.
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Affiliation(s)
- Gemma Pearce
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Occupational Therapy Department, Concord Repatriation General Hospital, Concord, NSW 2139, Australia
| | - Joan O’Donnell
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Rebecca Pimentel
- Occupational Therapy Helping Children, Frenchs Forest, NSW 2086, Australia
| | - Elizabeth Blake
- Occupational Therapy Department, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Lynette Mackenzie
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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Mota DMS, Moraes ÍAP, Papa DCR, Fernani DCGL, Almeida CS, Tezza MHS, Dantas MTAP, Fernandes SMS, Ré AHN, Silva TD, Monteiro CBM. Bilateral Transfer of Performance between Real and Non-Immersive Virtual Environments in Post-Stroke Individuals: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3301. [PMID: 36834000 PMCID: PMC9963577 DOI: 10.3390/ijerph20043301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Post-stroke presents motor function deficits, and one interesting possibility for practicing skills is the concept of bilateral transfer. Additionally, there is evidence that the use of virtual reality is beneficial in improving upper limb function. We aimed to evaluate the transfer of motor performance of post-stroke and control groups in two different environments (real and virtual), as well as bilateral transfer, by changing the practice between paretic and non-paretic upper limbs. (2) Methods: We used a coincident timing task with a virtual (Kinect) or a real device (touch screen) in post-stroke and control groups; both groups practiced with bilateral transference. (3) Results: Were included 136 participants, 82 post-stroke and 54 controls. The control group presented better performance during most parts of the protocol; however, it was more evident when compared with the post-stroke paretic upper limb. We found bilateral transference mainly in Practice 2, with the paretic upper limb using the real interface method (touch screen), but only after Practice 1 with the virtual interface (Kinect), using the non-paretic upper limb. (4) Conclusions: The task with the greatest motor and cognitive demand (virtual-Kinect) provided transfer into the real interface, and bilateral transfer was observed in individuals post-stroke. However, this is more strongly observed when the virtual task was performed using the non-paretic upper limb first.
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Affiliation(s)
- Deise M. S. Mota
- Physical Activity Sciences, School of Arts, Science and Humanities, University of São Paulo (EACH-USP), São Paulo 03828-000, Brazil
| | - Íbis A. P. Moraes
- Rehabilitation Sciences, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil
- Faculty of Medicine, University City of Sao Paulo (UNICID), São Paulo 03071-000, Brazil
| | - Denise C. R. Papa
- Medicine (Cardiology) at Escola Paulista de Medicina, Federal University of São Paulo (EPM/UNIFESP), São Paulo 04021-001, Brazil
| | - Deborah C. G. L. Fernani
- Department of Physiotherapy, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente 19050-920, Brazil
| | - Caroline S. Almeida
- Department of Physiotherapy, University of Medical Sciences of Santa Casa of São Paulo, São Paulo 01224-001, Brazil
| | - Maria H. S. Tezza
- Physical Activity Sciences, School of Arts, Science and Humanities, University of São Paulo (EACH-USP), São Paulo 03828-000, Brazil
| | - Maria T. A. P. Dantas
- Department of Physiotherapy, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente 19050-920, Brazil
| | - Susi M. S. Fernandes
- Department of Physiotherapy, Mackenzie Presbyterian University (UPM), São Paulo 01302-907, Brazil
| | - Alessandro H. N. Ré
- Physical Activity Sciences, School of Arts, Science and Humanities, University of São Paulo (EACH-USP), São Paulo 03828-000, Brazil
| | - Talita D. Silva
- Rehabilitation Sciences, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil
- Faculty of Medicine, University City of Sao Paulo (UNICID), São Paulo 03071-000, Brazil
- Medicine (Cardiology) at Escola Paulista de Medicina, Federal University of São Paulo (EPM/UNIFESP), São Paulo 04021-001, Brazil
| | - Carlos B. M. Monteiro
- Physical Activity Sciences, School of Arts, Science and Humanities, University of São Paulo (EACH-USP), São Paulo 03828-000, Brazil
- Rehabilitation Sciences, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil
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Tingulstad A, Meneses-Echavez J, Evensen LH, Bjerk M, Berg RC. Effectiveness of work-related interventions for return to work in people on sick leave: a systematic review and meta-analysis of randomized controlled trials. Syst Rev 2022; 11:192. [PMID: 36064472 PMCID: PMC9446672 DOI: 10.1186/s13643-022-02055-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 08/22/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Long-term sick leave is a serious concern in developed countries and the cost of sickness absence and disability benefits cause major challenges for both the individual and society as a whole. Despite an increasing body of research reported by existing systematic reviews, there is uncertainty regarding the effect on return to work of workrelated interventions for workers with different diagnoses. The objective of this systematic review was to assess and summarize available research about the effects of work-related interventions for people on long-term sick leave and those at risk of long-term sick leave. METHODS We conducted a systematic review in accordance with international guidelines. Campbell Collaboration (Area: Social Welfare), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Embase, Epistemonikos, MEDLINE, PsycINFO, Scopus, and Sociological Abstracts were systematically searched in March 2021. Two authors independently screened the studies. We conducted risk of bias assessments and meta-analyses of the available evidence in randomized controlled trials (RCTs). The remaining comparisons were synthesized narratively. The certainty of evidence for each outcome was assessed. RESULTS We included 20 RCTs comprising 5753 participants at baseline from 4 different countries. The studies had generally low risk of bias. Our certainty in the effect estimates ranged from very low to moderate. Eight different interventions were identified. Meta-analysis revealed no statistically significant difference between multidisciplinary rehabilitation (MR) and usual care (US) (Risk Ratio [RR] 1.01; Confidence Interval [CI] 95% 0.70-1.48 at 12 months follow-up) and between MR and other active intervention (Risk Ratio [RR] 1.04; Confidence Interval [CI] 95% 0.86-1.25 at 12 months follow-up). Remaining intervention groups revealed marginal, or no effect compared to the control group. The results for the secondary outcomes (self-efficacy, symptom reduction, function, cost-effectiveness) showed varied and small effects in the intervention groups. CONCLUSION Overall, the present data showed no conclusive evidence of which work-related intervention is most effective for return to work. However, a handful of potential interventions exist, that may contribute to a foundation for future research. Our findings support the need for adequately powered and methodologically strong studies.
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Affiliation(s)
| | - Jose Meneses-Echavez
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway.,Facultad de Cultura Fisica, Deporte y Recreación, Universidad Santo Tomás, Bogotá, Colombia
| | - Line Holtet Evensen
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Maria Bjerk
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Rigmor C Berg
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine, University of Tromsø, Tromsø, Norway
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Coutts E, Cooper K. Interventions, barriers, and facilitators associated with return to work for adults following stroke: a scoping review protocol. JBI Evid Synth 2021; 19:3332-3339. [PMID: 34907147 DOI: 10.11124/jbies-20-00386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of this scoping review is to map what has been reported on interventions, barriers, and facilitators associated with return to work for adults with and without communication disorders following a stroke. INTRODUCTION Difficulties in returning to work following a stroke can have a significant impact on people's lives, not only in terms of the individual's finances (and the economy as a whole), but also in terms of the person's psychosocial adjustment, for example, their sense of role and purpose and their self-esteem. This scoping review aims to map the literature examining interventional approaches, barriers, and facilitators relevant to this topic. INCLUSION CRITERIA This review will include literature on the return to work for adults aged 16 years or older who have had a stroke. It will be restricted to research conducted in developed countries. METHODS Databases that will be searched include MEDLINE, CINAHL, Embase, AMED, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PEDRo, and OTSeeker. Gray literature or unpublished studies will be searched in OpenGrey and ProQuest Dissertations and Theses, as well as professional bodies and organizations whose remit includes stroke and vocational rehabilitation. The search will be limited to studies written in English since 2010. Titles and abstracts will be screened by two independent reviewers and full-text articles assessed against the inclusion criteria by two independent reviewers. Data will be extracted and the findings will be presented in tabular and graphical format along with a narrative summary.
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Affiliation(s)
- Emma Coutts
- Speech and Language Therapy, NHS Grampian, Fraserburgh, UK
| | - Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, UK.,The Scottish Centre for Evidence-based, Multi-professional Practice: A JBI Centre of Excellence, Aberdeen, UK
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Wei R, Zhang L, Hu W, Shang X, He Y, Zhang W. Zeb2/Axin2-Enriched BMSC-Derived Exosomes Promote Post-Stroke Functional Recovery by Enhancing Neurogenesis and Neural Plasticity. J Mol Neurosci 2021; 72:69-81. [PMID: 34401997 DOI: 10.1007/s12031-021-01887-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/05/2021] [Indexed: 01/04/2023]
Abstract
Exosomes harvested from bone marrow-derived mesenchymal stromal cells (BMSCs) have shown treatment potential in many diseases. In vitro, Zeb2/Axin2 stimulated endogenous neurogenesis, which induced functional recovery after stroke. Here, we investigated whether the Zeb2/Axin2-enriched exosomes harvested from BMSCs transfected with a Zeb2/Axin2 overexpression plasmid would enhance neurological recovery. Compared with the control, both exosome treatments significantly improved functional recovery, and Zeb2/Axin2-enriched exosomes had significantly more improved effects on neurological function, neurogenesis, and neurite remodeling/neuronal dendrite plasticity than the control BMSC exosome treatment in a middle cerebral artery occlusion MCAO rat model. After stimulation with Zeb2/Axin2-enriched BMSC exosomes, the spatial memory and nerve function of MCAO rats showed marked recovery. The number of neurons was increased in the subventricular zone (SVZ), hippocampus, and cortex area, while the expression of nerve growth factors (NGF, BDNF, etc.) was upregulated. In the ischemic boundary zone, Zeb2/Axin2-enriched exosomes promoted synaptic remodeling by increasing the number of synapses and reversed the axonal loss of phosphorylated neurofilament (SMI-31) and synaptophysin (SYN) caused by ischemic injury, thus alleviating axonal demise and promoting synaptic proliferation. In vitro, Zeb2/Axin2-enriched exosomes significantly increased neurite branching and elongation of cultured cortical embryonic rat neurons under oxygen- and glucose-deprived (OGD) conditions. Moreover, Ex-Zeb2/Axin2-enriched exosomes downregulated the protein level of SOX10, endothelin-3/EDNRB, and Wnt/β-catenin expression. In conclusion, exosomes harvested from Ex-Zeb2/Axin2 BMSC could improve post-stroke neuroplasticity and functional recovery in MCAO rats by promoting proliferation and differentiation of neural stem cells. The mechanism may be related to the SOX10, Wnt/β-catenin, and endothelin-3/EDNRB pathways.
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Affiliation(s)
- Rui Wei
- Department of Emergency, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Rd, Kunming, 650032, Yunnan, China
| | - Lin Zhang
- Department of Rehabilitation, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Rd, Kunming, 650032, Yunnan, China
| | - Wei Hu
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Rd, Kunming, 650032, Yunnan, China
| | - Xinying Shang
- Department of Emergency, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Rd, Kunming, 650032, Yunnan, China
| | - Yuyan He
- Kunming Medical University, No. 1168 West Chunrong Road, Kunming, 650504, Yunnan, China
| | - Wei Zhang
- Department of Emergency, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Rd, Kunming, 650032, Yunnan, China.
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Mol TI, van Bennekom CA, Schepers VP, Ter Hoeve N, Kruitwagen-van Reenen ET, Visser-Meily JM, Post MW. Differences in Societal Participation Across Diagnostic Groups: Secondary Analyses of 8 Studies Using the Utrecht Scale for Evaluation of Rehabilitation-Participation. Arch Phys Med Rehabil 2021; 102:1735-1745. [PMID: 33757804 DOI: 10.1016/j.apmr.2021.02.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/16/2021] [Accepted: 02/22/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine differences in participation problems between diagnostic groups and to examine diagnosis as a determinant of participation with and without statistically accounting for confounders. DESIGN Secondary analyses of data from 8 studies. SETTING Community, the Netherlands. PARTICIPANTS Participants (N=1735) in diagnostic groups: stroke (n=534), subarachnoid hemorrhage (n=104), other acquired brain injury (n=163), progressive neurologic diseases (n=112), acute coronary syndrome (n=536), and spinal cord injury (n=286). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participation was measured with the Utrecht Scale for Evaluation of Rehabilitation-Participation. This measure has 3 scales: Restrictions, Satisfaction, and Frequency. In this study, scores were also computed for 3 domains across these scales: Productivity, Leisure, and Social. Scores ranged from 0 (worst) up to 100 (best). Possible confounders were age, sex, level of education, marital status, and time since onset of the condition. RESULTS Significant differences were found in levels of participation between diagnostic groups. Individuals with acute coronary syndrome showed better participation scores in all scales and domains compared with most or all other diagnostic groups, except for the Social domain. Individuals with progressive neurologic diseases showed the lowest (worst) Restriction and Satisfaction scores, whereas those with stroke showed the lowest Frequency scores. After correcting for confounders, diagnosis explained significant proportions of the variance of participation (Frequency, 6.4%; Restrictions, 15.1%; Satisfaction, 5.1%; Productivity, 13.2%; Leisure, 13.8%; Social, 6.9%). CONCLUSIONS Participation problems occurred in all 6 diagnostic groups within this study. Differences were found in participation between diagnostic groups, demonstrating diagnosis-specific participation profiles, including after correcting for confounders.
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Affiliation(s)
- Tanja I Mol
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen
| | - Coen A van Bennekom
- Heliomare Rehabilitation Center, Research and Development and Institute of Vocational Assessment and Education, Wijk aan Zee; Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam
| | - Vera P Schepers
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht; Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht
| | - Nienke Ter Hoeve
- Capri Cardiac Rehabilitation, Rotterdam; Department of Rehabilitation Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Esther T Kruitwagen-van Reenen
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht; Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht
| | - Johanna M Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht; Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht
| | - Marcel W Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen.
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Leary S, Hurford J, Shanahan N. An expert opinion: Vocational rehabilitation after stroke. ADVANCES IN CLINICAL NEUROSCIENCE & REHABILITATION 2020. [DOI: 10.47795/oeap6518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Less than half of people return to work following a stroke. For those who do, their return is often complicated by residual 'invisible' symptoms. It is important to ask about work and to provide intervention early in the rehabilitation process. Specialist vocational rehabilitation services can support more complex and long-term interventions, but there is a paucity of service provision which needs to be addressed.
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Guo Y, Lin B, Zhang Z, Fu B, Wang Y, Qi B. Cross-Cultural Adaptation and Validation of the Chinese Version of the Work-Ability Support Scale (WSS) in Young and Middle-Aged Stroke Survivors. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:646-655. [PMID: 32020495 DOI: 10.1007/s10926-020-09878-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose To translate and cross-culturally adapt the Work-Ability Support Scale (WSS) into Chinese and evaluate the reliability and validity of the measure among young and middle-aged stroke survivors. Methods A total of 210 participants aged 28-60 years were recruited from two communities in Zhengzhou. Item analysis, internal consistency, inter-rater reliability, and construct validity were tested. Results A moderate level of correlation between the items and the domains (r > 0.60), and the significant differences in items between the high group and the low group were tested by independent sample t-tests (P < 0.001). For Part A, Cronbach's α of the domains "physical", "thinking and communication", and "social/behavioural" was 0.865, 0.857 and 0.912, respectively. The Cronbach's α coefficient of Part A of the WSS was calculated as 0.931. The Cronbach's α of Part B was 0.761, with Cronbach's α values of 0.795, 0.649 and 0.643 for "personal factors", "environmental factors (within the workplace)", and "barriers to return to work", respectively. The split-half coefficients of Parts A and B were assessed as 0.804 and 0.559, respectively. The kappa coefficient of the other items all exceeded 0.60 (P < 0.001), except for a few items. The scale-level content validity index (S-CVI) was 0.94 and 0.90 for Parts A and B, respectively. The original construct of the scale was examined by confirmatory factor analysis (CFA), and model fit indices were mostly satisfactory. Conclusion The WSS is a reliable and valid tool for measuring young and middle-aged Chinese stroke survivors' work ability and support needs during their return to work.
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Affiliation(s)
- Yawen Guo
- School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China
| | - Beilei Lin
- School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China
| | - Zhenxiang Zhang
- School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China.
| | - Bo Fu
- School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China
| | - Yongli Wang
- School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China
| | - Bei Qi
- School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China
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