Can stroke specific vocational rehabilitation (SSVR) be delivered and measured?: feasibility RCT and economic analysis
Background: A quarter of UK strokes occur in working age people. Fewer than half resume work. Rehabilitation frequently fails to address work needs and evidence for post-stroke vocational rehabilitation is lacking. This pilot trial tested the feasibility of delivering SSVR and measuring its effec...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
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SAGE
2014
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| Online Access: | https://eprints.nottingham.ac.uk/39880/ |
| _version_ | 1848795935971213312 |
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| author | Radford, Kathryn A. Grant, Mary Sinclair, Emma Terry, Jane Sampson, Christopher James Edwards, Claire Walker, Marion F. Lincoln, Nadina Drummond, Avril E.R. Phillips, Julie Watkins, Louise Rowley, Emma Brain, Nicola Guo, Boliang Jarvis, M. Jenkinson, M. |
| author_facet | Radford, Kathryn A. Grant, Mary Sinclair, Emma Terry, Jane Sampson, Christopher James Edwards, Claire Walker, Marion F. Lincoln, Nadina Drummond, Avril E.R. Phillips, Julie Watkins, Louise Rowley, Emma Brain, Nicola Guo, Boliang Jarvis, M. Jenkinson, M. |
| author_sort | Radford, Kathryn A. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background:
A quarter of UK strokes occur in working age people. Fewer than half resume work. Rehabilitation frequently fails to address work needs and evidence for post-stroke vocational rehabilitation is lacking. This pilot trial tested the feasibility of delivering SSVR and measuring its effects and costs compared to usual care (UC).
Method:
Previously employed stroke survivors (SS) aged ≥16 recruited from a stroke unit were randomised to receive SSVR or UC. Exclusion criteria: refusing consent; not intending to work, medical preclusion. Primary outcomes: occupational and benefit status. Mood, function, participation, quality of life and resource use were measured using standardized and bespoke postal questionnaires at 3, 6 and 12 months. Service use was cross-referenced in 10% of participants and costs calculated.
Results:
46/126 patients screened (36 men, mean 56 (SD 12.7, 18-78 years) were recruited in 15 months; 40 declined. Most (29) had NIHSS scores ≤ 15, were in professional roles (65%), self-employed (21.7%) at onset. 32 available at 12-month follow-up, with poorer response (61%) among UC. Intervention successfully deployed in 22/23 cases. 39% returned to work at 12 months - twice as many in SSVR. More depression and productivity loss in UC, especially at 6 mths. Cross-referencing for 5 participants involved 51 phone calls, 23 letters/emails. Self-reported and actual service use data were discrepant. SS underestimated GP& consultant and overestimated therapy input.
Discussion:
SSVR can be delivered and its effects and costs measured. More reliable methods of capturing service use, income and benefit data and clearer definitions of work are needed.
Conclusion:
Findings inform the definitive trial. |
| first_indexed | 2025-11-14T19:40:00Z |
| format | Article |
| id | nottingham-39880 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:40:00Z |
| publishDate | 2014 |
| publisher | SAGE |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-398802020-05-04T16:45:28Z https://eprints.nottingham.ac.uk/39880/ Can stroke specific vocational rehabilitation (SSVR) be delivered and measured?: feasibility RCT and economic analysis Radford, Kathryn A. Grant, Mary Sinclair, Emma Terry, Jane Sampson, Christopher James Edwards, Claire Walker, Marion F. Lincoln, Nadina Drummond, Avril E.R. Phillips, Julie Watkins, Louise Rowley, Emma Brain, Nicola Guo, Boliang Jarvis, M. Jenkinson, M. Background: A quarter of UK strokes occur in working age people. Fewer than half resume work. Rehabilitation frequently fails to address work needs and evidence for post-stroke vocational rehabilitation is lacking. This pilot trial tested the feasibility of delivering SSVR and measuring its effects and costs compared to usual care (UC). Method: Previously employed stroke survivors (SS) aged ≥16 recruited from a stroke unit were randomised to receive SSVR or UC. Exclusion criteria: refusing consent; not intending to work, medical preclusion. Primary outcomes: occupational and benefit status. Mood, function, participation, quality of life and resource use were measured using standardized and bespoke postal questionnaires at 3, 6 and 12 months. Service use was cross-referenced in 10% of participants and costs calculated. Results: 46/126 patients screened (36 men, mean 56 (SD 12.7, 18-78 years) were recruited in 15 months; 40 declined. Most (29) had NIHSS scores ≤ 15, were in professional roles (65%), self-employed (21.7%) at onset. 32 available at 12-month follow-up, with poorer response (61%) among UC. Intervention successfully deployed in 22/23 cases. 39% returned to work at 12 months - twice as many in SSVR. More depression and productivity loss in UC, especially at 6 mths. Cross-referencing for 5 participants involved 51 phone calls, 23 letters/emails. Self-reported and actual service use data were discrepant. SS underestimated GP& consultant and overestimated therapy input. Discussion: SSVR can be delivered and its effects and costs measured. More reliable methods of capturing service use, income and benefit data and clearer definitions of work are needed. Conclusion: Findings inform the definitive trial. SAGE 2014-03-05 Article PeerReviewed Radford, Kathryn A., Grant, Mary, Sinclair, Emma, Terry, Jane, Sampson, Christopher James, Edwards, Claire, Walker, Marion F., Lincoln, Nadina, Drummond, Avril E.R., Phillips, Julie, Watkins, Louise, Rowley, Emma, Brain, Nicola, Guo, Boliang, Jarvis, M. and Jenkinson, M. (2014) Can stroke specific vocational rehabilitation (SSVR) be delivered and measured?: feasibility RCT and economic analysis. Clinical Rehabilitation, 28 (4). pp. 403-415. ISSN 1477-0873 http://journals.sagepub.com/doi/pdf/10.1177/0269215513506172 doi:10.1177/0269215513506172 doi:10.1177/0269215513506172 |
| spellingShingle | Radford, Kathryn A. Grant, Mary Sinclair, Emma Terry, Jane Sampson, Christopher James Edwards, Claire Walker, Marion F. Lincoln, Nadina Drummond, Avril E.R. Phillips, Julie Watkins, Louise Rowley, Emma Brain, Nicola Guo, Boliang Jarvis, M. Jenkinson, M. Can stroke specific vocational rehabilitation (SSVR) be delivered and measured?: feasibility RCT and economic analysis |
| title | Can stroke specific vocational rehabilitation (SSVR) be delivered and measured?: feasibility RCT and economic analysis |
| title_full | Can stroke specific vocational rehabilitation (SSVR) be delivered and measured?: feasibility RCT and economic analysis |
| title_fullStr | Can stroke specific vocational rehabilitation (SSVR) be delivered and measured?: feasibility RCT and economic analysis |
| title_full_unstemmed | Can stroke specific vocational rehabilitation (SSVR) be delivered and measured?: feasibility RCT and economic analysis |
| title_short | Can stroke specific vocational rehabilitation (SSVR) be delivered and measured?: feasibility RCT and economic analysis |
| title_sort | can stroke specific vocational rehabilitation (ssvr) be delivered and measured?: feasibility rct and economic analysis |
| url | https://eprints.nottingham.ac.uk/39880/ https://eprints.nottingham.ac.uk/39880/ https://eprints.nottingham.ac.uk/39880/ |