Functioning and Disability Evaluation as an Asset for Vocational Rehabilitation in Neurological Conditions

  • Matilde Leonardi
  • Davide Sattin
  • Rui Quintas
  • Ambra Mara Giovannetti
  • Alberto RaggiEmail author
Part of the Handbooks in Health, Work, and Disability book series (SHHDW)


The purpose of vocational rehabilitation (VR) is to facilitate the return to work (RTW) or the maintenance of a work position of a person with a disability. VR interventions have to start with a preliminary evaluation of a person’s functioning, but despite the calls to use instruments based on the International Classification of Functioning, Disability and Health (ICF), no data have yet been reported using a standardised ICF-based evaluation of functioning. In this chapter we aim to connect ICF-based evaluation of functioning and disability with experiences of its application to VR in patients with multiple sclerosis (MS), stroke and traumatic brain injury (TBI), highlighting elements of strength and weakness. ICF-based descriptions of the three neurological conditions, together with identification of key issues related to RTW and job maintenance as well as available and published experiences with VR programmes, are reported. The impact of a tailored rehabilitation plan for return to work has also been measured in terms of indirect costs. Indirect costs, i.e. those related to lower employment rates and reduced productivity, are responsible for 32 % of total MS costs, 8 % of total stroke costs and 59 % of total TBI costs. VR has proven to be effective in 48 % of clients with MS, 12–48 % of those with stroke and 38–84 % of those with TBI. Paucity of available data, inconsistency in “work” definitions, lack of systematic reporting of VR programmes’ duration and almost complete absence of cost-effectiveness analyses are still critical issues that future research activities will need to address.


Multiple Sclerosis Traumatic Brain Injury Multiple Sclerosis Patient Expand Disability Status Scale Traumatic Brain Injury Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Matilde Leonardi
    • 1
  • Davide Sattin
    • 1
  • Rui Quintas
    • 1
  • Ambra Mara Giovannetti
    • 1
  • Alberto Raggi
    • 1
    Email author
  1. 1.Neurology, Public Health and Disability UnitNeurological Institute C. Besta IRCCS FoundationMilanItaly

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