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Return to work for adults following stroke: a scoping review of interventions, factors, barriers, and facilitators.

Coutts, Emma; Cooper, Kay


Emma Coutts


This scoping review aimed to map the literature on interventions, barriers, and facilitators for return to work for adults post-stroke with and without communication disorders. 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. This review considered literature that reported on interventions, barriers, and facilitators for return to work for adults (aged 16 and over) 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. 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 a narrative supported by tables. One hundred and six records were included, 61 of which addressed demographic-, socioeconomic-, impairment- and recovery-based factors associated with return to work. One of these 61 records, a narrative review focused on communication disorders. Thirty-eight records explored barriers and facilitators for return to work from different stakeholders' perspectives; 3 of these 38 records, including 2 qualitative studies and 1 narrative review, focused on post-stroke communication disorders. Eleven records focused on interventions, including 7 studies (reported across 9 records) that developed or tested return-to-work interventions. Of these primary studies, 1 randomized controlled trial and 1 retrospective cohort study was identified. The remaining intervention studies were case studies or case series. None of these intervention studies addressed communication disorders. 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 to facilitate 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.


COUTTS, E. and COOPER, K. 2023. Return to work for adults following stroke: a scoping review of interventions, factors, barriers, and facilitators. JBI evidence synthesis [online], 21(9), pages 1794-1837. Available from:

Journal Article Type Article
Acceptance Date Jan 24, 2023
Online Publication Date Jun 1, 2023
Publication Date Sep 30, 2023
Deposit Date Jun 5, 2023
Publicly Available Date Jun 2, 2024
Journal JBI Evidence Synthesis
Print ISSN 2689-8381
Electronic ISSN 2689-8381
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 21
Issue 9
Pages 1794-1837
Keywords Aphasia; Dysarthria; Return to work; Speech disorders; Stroke
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Additional Information This article has been published with separate supporting information. This supporting information has been incorporated into a single file on this repository and can be found at the end of the file associated with this output.
The file accompanying this file is the Author Accepted Manuscript and has a different title from the published version.