Occupational Therapy in Return-to-Work Processes After Stroke: A Scoping Review of Ongoing Therapeutic Support and Implications for Work-Treatment Balance.
Return to work (RTW) after stroke is a complex process influenced by residual impairments, workplace demands, and rehabilitation support. However, how therapeutic support is structurally incorporated into RTW processes and the specific contributions of occupational therapy (OT) remain unclear.
This scoping review is aimed at examining how therapeutic support is incorporated into RTW processes following stroke and at clarifying the roles of OT within these support structures.
Comprehensive literature searches were conducted in Ichushi-Web, PubMed, and Web of Science, complemented by manual searches. Studies published in Japanese or English up to February 2026 were included if they addressed stroke survivors and work participation-related support. Data were extracted using a structured framework to map therapeutic integration during RTW and OT roles. Facilitators, barriers, and assessment approaches were also summarized.
Fifty-eight studies met the inclusion criteria. Therapeutic support was described at different stages of the RTW process, ranging from interventions completed before work resumption to support provided alongside RTW and support integrated with workplace demands. OT roles were identified across 10 categories, most commonly involving work participation-oriented assessment and job analysis, employer liaison and stakeholder meetings and mediation, and workplace evaluation and accommodations. Functional impairments and fatigue were frequently reported as barriers to sustained work participation; however, fatigue-specific assessments were reported less frequently.
Therapeutic integration within ongoing work participation is a key structural feature of RTW support for stroke survivors and may also be relevant to how work-treatment balance (WTB) is addressed in practice. The findings highlight the diverse roles of OT in linking worker capacity, workplace demands, and service coordination. They also suggest a discrepancy between commonly reported barriers, particularly fatigue, and the assessment approaches used in RTW-focused studies.
This scoping review is aimed at examining how therapeutic support is incorporated into RTW processes following stroke and at clarifying the roles of OT within these support structures.
Comprehensive literature searches were conducted in Ichushi-Web, PubMed, and Web of Science, complemented by manual searches. Studies published in Japanese or English up to February 2026 were included if they addressed stroke survivors and work participation-related support. Data were extracted using a structured framework to map therapeutic integration during RTW and OT roles. Facilitators, barriers, and assessment approaches were also summarized.
Fifty-eight studies met the inclusion criteria. Therapeutic support was described at different stages of the RTW process, ranging from interventions completed before work resumption to support provided alongside RTW and support integrated with workplace demands. OT roles were identified across 10 categories, most commonly involving work participation-oriented assessment and job analysis, employer liaison and stakeholder meetings and mediation, and workplace evaluation and accommodations. Functional impairments and fatigue were frequently reported as barriers to sustained work participation; however, fatigue-specific assessments were reported less frequently.
Therapeutic integration within ongoing work participation is a key structural feature of RTW support for stroke survivors and may also be relevant to how work-treatment balance (WTB) is addressed in practice. The findings highlight the diverse roles of OT in linking worker capacity, workplace demands, and service coordination. They also suggest a discrepancy between commonly reported barriers, particularly fatigue, and the assessment approaches used in RTW-focused studies.