Could extra rehabilitation help people return to work earlier after a stroke?

A research team led by the University of Nottingham is leading a major national trial to find out whether additional rehabilitation support for people who have had a stroke could help them to return to work earlier.

The four-year study will look at whether offering an early intervention in addition to the usual NHS rehabilitation could be more successful and cost effective for helping stroke survivors to return to work than just NHS rehab alone.

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It has been funded with a £1.8 million grant by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme.

There are more than 100,000 strokes in the UK every year and more than 1.2 million stroke survivors living in the UK. Stroke is often associated with older people but around one-quarter of stroke survivors are of working age. Many want to return to work but fewer than half of those working at the time of stroke do so. This has huge personal and economic impact. Although the severity of the stroke can impact on people’s working life and ability to do their job, other factors such as the stroke survivors beliefs and workplace factors can also affect the chances of successfully returning to work

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The new study is being led by Dr Kate Radford, Occupational Therapist and Associate Professor in Rehabilitation Research in the School of Medicine at the University of Nottingham.

She said: “We are excited to see whether providing the right type of support to stroke survivors and employers at the right time will optimise stroke survivors’ opportunities for returning to and remaining in work and result in improved health and economic outcomes.”

The national trial, known as RETAKE, will combine conventional occupational therapy with a tailored assessment of the impact of stroke on the person and their job role, matching the stroke limitations to job demands and negotiating reasonable adjustments with employers to ensure the stroke survivor can return to and remain at work.

The study team will include an economic evaluation to test the cost effectiveness of the new intervention, an evaluation of what was delivered as a result of the trial and will canvass the views of stroke survivors and staff on it.

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More than 750 stroke survivors will be recruited from 20 NHS centres over 20 months. Around half of the volunteers will be randomly selected to receive the new intervention, while the remaining stroke survivors will receive the standard NHS care alone.

The researchers will follow up with participants by a postal questionnaire at three, six and 12 months and offer telephone interviews when needed to find out about their rehabilitation progress and work status.

The study will be carried out in collaboration with researchers at the universities of Central Lancashire, Leeds, Manchester, King’s College London and East Anglia.

They will be working in partnership with stroke survivors, stroke service providers and employer and patient public involvement (PPI) representatives to deliver the study.