Interventions to promote work participation after ischaemic stroke: A systematic review.

Only a disappointingly low proportion of patients successfully engage in professional activities after ischaemic stroke. This systematic review maps all contemporary evidence regarding interventions aiming to promote return-to-work in survivors of ischaemic stroke. We performed a search according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and searched five reference databases. Prospective trial registers and grey literature were also assessed, and we executed backwards and forward reference searching. The study protocol was registered in PROSPERO (CRD42017077796). The search yielded 444 records of which 174 were duplicates. Backward and forward reference searching resulted in 808 unique records. Eleven articles were retained for full-text analysis and two met the selection criteria. A controlled before-after study showed beneficial effects of intravenous thrombolytic treatment in patients with moderate to severe acute ischaemic stroke. A retrospective study with low methodological quality reported improved vocational outcome of an outpatient rehabilitation program in patients with mild to moderate ischaemic stroke. We conclude that there currently is insufficient evidence regarding the effectiveness of interventions to promote return-to-work in patients with ischaemic stroke, though intravenous thrombolytic therapy has shown beneficial effects and there are indications that rehabilitation programs may also be advantageous.