Introduction: return to work is a challenging task among work-active stroke survivors, which has been widely analyzed, but few data has been collected regarding the performance quality compared to previous state before stroke.
Hypothesis: work performance after stroke is not only determined by the probability of being active in daily job activities, but also in the ability to recover different cognitive and motor areas to perform tasks as previous.
Methods: we developed a 15-item survey (work performance questionnaire [WPQ]) for stroke survivors who returned to work, and applied the instrument on those who had more than 3 months in their work activity; patients were selected from the INNN-stroke database, with demographic and epidemiological characteristics collected on each patient. The survey evaluated 11-different domains (language, memory, attention, planning, calculus, writing, motor skills, gait, visual, mood and self-perception). Points were assigned according to 4 categories: high (0-5 points), good (6-15 points), moderate (16-29 points) and low performance (30-45 points). Internal consistency, test-retest reliability, item-scale correlation and factor analysis were conducted.
Results: A total of 100 ischemic stroke survivors were recruited (51% female patients, median age 42 years [IQR 34.5-54.5 years]); median time after returning to work was 4 months (IQR 2-7 months), with 39 patients decreasing the work-schedule to part time job, and 100% of subjects keeping the same work activity than previous to the index stroke. Work performance after stroke was high in 16% cases, good in 58% cases, moderate in 24% cases, and low in 2 cases. Chronbach’s alpha coefficient was 0.75 for the scale. Kaiser-Meyer-Olkin measure of sampling adequacy was 0.72 (p<0.001). The test-retest reliability, as estimated by the intraclass correlation coefficients was good. Memory, Language and Attention explained 59.7% of the variance of the questionnaire at the extraction analysis.
Conclusions: The WPQ-INNN is a reliable and valid tool for assessment of performance quality in stroke survivors who returned to work, with the highest prediction ability based on memory, language and attention. This instrument should be validated in prospective studies.