Purpose and aim of the study:

According to the health professions council of South Africa scope of physiotherapy practice rehabilitation includes: “getting the patient to maximum potential in both work and sport, including adaptation to permanent disabilities”. There is a need to ensure that patients who can go back to work after stroke do so, because returning to work may contribute significantly to their life satisfaction, wellbeing, self worth and social identity. Returning to work provides an opportunity to maintain independence with the income generated through employment. The aim of this study was to determine current practice in return to work (RTW) services rendered for patients with stroke.

Methodology:

A cross sectional survey was performed using a self administered questionnaire which was posted with an information document to all stroke rehabilitation units (n = 53) and 36 (68%) questionnaires were returned. Each facility was sent one questionnaire and was requested to send the responses based on consensus among therapists working in that particular facility.

Results:

Seventeen (47%) of the 36 clinical settings referred patients to facilities offering RTW services; 12 (33%) facilities did not refer patients for RTW and did not offer RTW services and seven (20%) facilities offered RTW services. Of the seven facilities that rendered post stroke RTW services five (71%) communicated with the employer to discuss reasonable accommodation; four (57%) did assessments for potential to return to work; three (43%) used work samples to assess for potential to return to work, one (14%) used Functional Independence Measure and the Barthel Index to assess for potential to return to work; two (29%) did work visit to assess physical job demands, one (14%) gave the employer regular feedback about patient progress; and three (43%) rendered RTW rehabilitation services within the hospital and at the workplace. The most common reason given for not offering RTW services was that they referred patients to other therapists who offered these services. The second most common reason was that patients were unemployed at the time of having stroke.

Conclusion:

 A small number of clinical facilities in the Gauteng province of South Africa assess their patients to establish potential for return to work after stroke and a small number of clinical facilities render RTW intervention for patients with stroke.

Ethical clearance for this study was granted by the University of the Witwatersrand committee for research on human subjects (clearance number M081132)