Return to Work After Stroke

  • Akizumi TsutsumiEmail author
Living reference work entry
Part of the Handbook Series in Occupational Health Sciences book series (HDBSOHS, volume 1)


Stroke is recognized as the single largest cause of severe disability worldwide. The cost of stroke is greater for young people because of a greater loss in productivity. Return to work (RTW) following stroke represents a major psychosocial complication. Approximately 40%–55% of patients with stroke need active rehabilitation, and 60% of stroke survivors need job modification after stroke. Factors associated with RTW include functional recovery, higher brain dysfunction, post-stroke fatigue and depression, socioeconomic status, employer flexibility, social benefits, and support from family or coworkers. Although rehabilitation techniques have been improved and some rehabilitation programs have been shown to be effective, there is a paucity of studies on vocational outcomes after stroke. RTW after stroke is a challenge for younger stroke survivors as well as for the older working population in general and people with disabilities who want to work. The system of RTW for workers with disabilities, such as disease treatment (including rehabilitation), workplace accommodation, and cooperation and coordination among stakeholders, should be consolidated. Overcoming the challenges of RTW after stroke is a key milestone for harmonizing work and disease treatment.


Fitness for work Functional disability Harmonizing work and disease treatment Higher brain dysfunction Psychosocial work environment Rehabilitation Social determinants Workplace accommodation 



This work was supported by Ministry of Health, Labour and Welfare (Industrial Disease Clinical Research Grants: Grant Number 170401 and 180701-1). We also thank Audrey Holmes, MA, from Edanz Group ( for editing a draft of this manuscript.


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Public HealthKitasato University School of MedicineSagamiharaJapan

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