PTOTSLPCohortArchives of physical medicine and rehabilitation2025

Employment Outcomes Among Clients With Stroke Utilizing Public Vocational Rehabilitation Services in the United States.

Chen Lin, Jinhee Park, Eun-Jeong Lee

PMID 39709024

WHAT IT FOUND

Stroke survivors using vocational rehab had a 36.4% competitive employment rate.

Short-term job supports, placement help, and rehab tech linked to better outcomes. Job search assistance and assessments linked to worse outcomes. Disability benefits and longer service duration also linked to lower employment rates.

Key findings

01Short-term job supports, job placement assistance, rehabilitation technology supports, maintenance services, and counseling were associated with higher odds of competitive employment.

02Job search assistance and assessment services were associated with lower odds of competitive employment, possibly reflecting greater stroke severity or need for new roles.

03Receipt of SSI or SSDI was associated with a 38% reduction in finding competitive employment.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The study used administrative data, so stroke severity, specific medical details, and functional limitations were not controlled for. There was no comparison group of individuals with stroke who did not receive VR services, so the effectiveness of VR itself cannot be isolated. The sample represents only those who accessed and completed VR services, potentially excluding those with more severe disabilities or greater barriers. Data entry errors by VR counselors are possible, and the dataset lacks a gender variable. The study period overlapped with the COVID-19 pandemic, which may have influenced employment outcomes. Associations do not imply causation; for example, job search assistance may have been provided to those with more severe barriers.

Declared interests

The authors declared no conflicts of interest. The study was supported by the U.S. Government (Non-P.H.S.).

The easy way to misread this

Do not interpret the negative association between job search assistance and employment as evidence that this service causes poor outcomes. It likely reflects reverse causality, where individuals with more severe disabilities or greater barriers were more likely to require extensive job search support.

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