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Returning to Work Post-Stroke


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.