Stroke is the single greatest cause of adult disability in the UK. A quarter of strokes affect people of working age; however, less than half of them return to work. This study described the nature of return to work and the help that people require to go back to work. A total of 46 participants were recruited from one English county. Participants were divided into 2 groups: a group receiving usual care and a group receiving extra rehabilitation. The study assessed their work status, the hours they worked, work accommodations, and what they earned at baseline, 3, 6 and 12 months after stroke. Most people returned to work after a mean of 90 days and stayed with the same employer. However, many people needed changes at work, worked fewer hours and earned less than they did before the stroke. Future research should investigate the implications of work adjustments for stroke survivors and whether the reported reductions in hours, status, roles and responsibilities are viewed as positive or negative. Objective: Stroke is the greatest cause of disability in adults. A quarter of strokes in the UK affect people of working age, yet under half of them return to work after stroke. There has been little investigation into what constitutes "return to work" following stroke. The aim of this study is to describe the work metrics of stroke survivor participants in a feasibility randomized controlled trial of an early stroke-specific vocational rehabilitation intervention. Methods: Retrospective analysis of trial data. Metrics on work status, working hours, workplace accommodations and costs were extracted from trial outcomes gathered by postal questionnaire at 3, 6, and 12 months' post-randomization for 46 stroke participants in a feasibility randomized controlled trial. Participants were randomized to receive vocational rehabilitation (intervention) or usual care (control). Results: Two-thirds (n = 29; 63%) of participants returned to work at some point in the 12 months following stroke. Participants took a mean of 90 days to return to work. Most returned to the same role with an existing employer. Only one-third of participants who were employed full-time at stroke onset were working full-time at 12 months post-stroke. Most participants experienced a reduction in pre-stroke earnings. Workplace accommodations were more common among intervention group participants. More intervention participants than control participants reported satisfaction with work at both 6 and 12 months post-randomization. Conclusion: This study illustrates the heterogeneous nature of return to work and the dramatic impact of stroke on work status, working hours and income. Longitudinal research should explore the socioeconomic legacy of stroke and include clear definitions of work and accurate measures of working hours and income from all sources.

Background: Literature lacks a clear description of return to work following traumatic brain injury (TBI). Aim: to describe work metrics for people with mild and moderate/severe TBI at 3, 6, and 12 months post-injury.Methods: A retrospective cross-sectional analysis of 172 TBI participants measuring work outcomes up to 12-months post-injury. Metrics described vocational status, accommodations, satisfaction, hours, time taken to return, financial status, and responsibilities. Logistic regression identified factors indicative of complete (80% of preinjury hours) return to work.Results: 59/86 moderate/severely injured (68.6%) and 68/81 mildly injured (84%) people returned to work following TBI. 28 (16.3%) achieved a complete return by 12 months. The regression model was statistically significant X 2 (4) = 51.980, p = <.0005, suggesting that those with high health related quality of life, anxiety and functional ability were more likely to achieve complete return to work. At 12 months, 41 participants (23.8%) had workplace accommodations. 115 (66.9%) were less content with their job and many reported reduced working hours.Discussion: This study highlights the heterogeneity of work post-TBI. Even people with 'mild' TBI fail to make a complete return to work by 12 months. Conclusions: Further longitudinal research is needed to explore the personal and economic legacy of TBI.