Returning to Work Post-Stroke
08/27/2021
Health professionals may take a renewed focus on minimizing
post-stroke fatigue for patients, thanks to a new study showing post-stroke
fatigue is highly associated with the inability to return to work up to 12
months post discharge. The study examined both inpatients and outpatients at
Élisabeth Bruyère Hospital between the ages of 18 and 60 who experienced a
first stroke.
Findings showed fatigue is a significant risk for inability
to resume employment 3, 6, and 12 months post-discharge, regardless of the
severity of stroke, age, cognitive impairment, or depression. This may be the
first study to investigate the return to work and driving in young stroke survivors
while controlling for these confounders.
Stroke is one of the leading causes of death and disability
in Canada, with global incidents rising in working aged adults. Recovering from
a stroke comes with its own set of challenges, and while younger stroke
survivors often face higher expectations for recovery, they also face an
increased pressure to return to work.
“Post-stroke fatigue is extremely common in stroke
survivors, yet it has been unrecognized or underestimated,” said Dr. Christine
Yang, principal investigator of the study and Medical Director, Rehabilitation
Medicine, Champlain Regional Stroke Network. “It is invisible compared to other
obvious physical deficits; however, it is often rated as one of three most
disabling problems after stroke. It is
beneficial to routinely screen post-stroke fatigue in rehabilitation and
educate stroke survivors and employers on the impacts of post-stroke fatigue on
return to work.”
At Bruyère, rehabilitation is provided to both inpatients
and outpatients as a part of stroke recovery, and ensuring patients understand
the effects they are experiencing and what it might mean as they resume their
daily life is a valuable part of a patient’s care plan.
Return to work was identified as a recommendation in the
Canadian Stroke Best Practice Guidelines, however, researchers noted patients
frequently reported substantial barriers in returning to work, where
post-stroke fatigue was reported as the greatest barrier within the first year
after stroke.
Health professionals can help patients explore strategies to
minimize post stroke fatigue, Dr. Yang recommended, including pacing, energy
conservation, sleeping hygiene, meditation, walking, and other graded physical
and cardiovascular exercises.
“With this knowledge, health care professionals can better
appreciate how stroke related fatigue is such an important aspect of their
patient’s health,” said Dr. Hillel Finestone, Director of Stroke Rehabilitation
Research at Bruyère. “Fatigue not only affects their patient’s ability to
return to work, but also to perform basic and important activities in day to
day life. This study is a valuable reminder to health care professionals that
stroke related fatigue is not just a minimal or unimportant symptom – it
affects the patient’s life for months after their stroke.”
The importance of being able to resume work is critical for
this demographic, as it not only provides financial security, but a successful
transition back to work has been shown to increase life satisfaction,
subjective well-being, and health-related quality of life. Understanding the
effects “invisible” impairments like fatigue have on stroke survivors can be
key to improving their care and rehabilitation delivery, and better prepare
patients in their recovery journey.
Read the full publication: Post-stroke
fatigue: A factor associated with inability to return to work in patients
<60 years – A 1-year follow-up.