OT reality of virtual vocational rehabilitation (VR) and other research updates in supporting workers with neurological conditions.
We've caught up on some of the latest research revelations from around the world in vocational rehabilitation (VR) for people with neurological conditions.
Here's a handful of those recent studies focusing on VR interventions and outcomes. How do yours stack up as a vocational rehab provider or recipient?
VR's virtual realities
To our knowledge, this study is the first to report on barriers to, facilitators for, and acceptability of a remotely delivered VR intervention for general trauma survivors. 
Jade Kettlewell et al. [2]
In what is being heralded as the first study of its type, researchers have identified best practice pointers in a virtual vocational rehabilitation programme for general trauma survivors.
The telehealth study involving occupational therapists (OTs) and clinical psychologists (CPs) was carried out as part of the UK project, Return to Work After Trauma (ROWTATE [1])
Funded by the National Institute for Health and Care Research (NIHR), the project aims to create a return-to-work programme specifically for trauma survivors that is also cost-effective for the National Health Service (NHS).
Testing ROWTATE's own virtual VR programme to see if it would work was a pivotal point in the five-year project, launched at Nottingham University in 2019.
And what they found was that remote VR provision was 'acceptable' to trauma survivors and therapists, with the benefits including:
- Good team working between OTs and CPs
- Reduced travel
- Wider geographical reach
- Greater flexibility in service delivery
- Better patient engagement
- Positive patient experiences
- Better communication with video versus telephone calls
However, to improve remote vocational rehabilitation, there were some significant barriers to overcome.
Some therapists reported difficulties engaging employers in VR approaches. Others felt they lacked the knowledge, confidence or will to provide vocational rehabilitation remotely.
And further hurdles were reported, including:
- Internet access and technology problems
- Privacy needs
- Disruptions
- Understanding home and work differences
- Extra challenges building therapeutic rapport
- The inability to carry out some assessments online
Find out more about ROWTATE's work to create a virtual VR model for trauma survivors and the support being given by patients, OTs, other health professionals and researchers here: [2]
Model VR
People with acquired brain injury (ABI), even severe injury, can be successful with returning to work when provided with appropriate support.
Alena Murray et al. [3]
Vocational rehabilitation (VR) can improve return-to-work rates and job stability for brain injury survivors, a study in Australia has affirmed after a wide-scale review of brain injury literature.
And while 'no gold standard' in VR post-brain injury was identified, the university researchers were able to pin down some vital good practice components.
Noting that VR for brain injury survivors involves 'a complex interaction of factors', they recommended a VR provider should consider the following:
- The person and their abilities
- Their job demands
- Their physical, social, and cultural environment
And to make vocational rehabilitation services effective, they should be:
- Accessible and timed
- Provided by an interdisciplinary team
- Actively engaged with stakeholders
More on this systematic scoping review aimed at 'identifying models, processes, and components of vocational rehabilitation following ABI' here: [3]
OT in MDT for MS
There was strong evidence for the effectiveness of multidisciplinary, cognitive and exercise approaches, physiotherapy, and occupational therapy…
Anne-Mette Hedeager Momsen et al [4]
Occupational therapists (OTs) have a crucial role to play in multidisciplinary rehabilitation for people with multiple sclerosis (MS).
That's one of the findings of an overview of rehabilitation reviews by the Danish research body DEFACTUM.
The study also recommends vocational rehabilitation (VR) as part of a multidisciplinary approach should start early because "work influences quality of life".
And interventions should include practical solutions for work adjustments and the education of managers.
Other conclusions based on the findings include the following:
- Experienced teams should perform rehab
- Rehab should target individual needs
- Family members should be involved in the rehab process
However, the study also noted that people with MS may not perceive their rehabilitation outcomes as expected. More on that here: [4]
VR for MS amid covid
Medical advances have resulted in the development of treatments that slow down the progression of [multiple sclerosis] and make it possible for individuals with MS to remain in the workforce longer than ever before.
Lynn C. Koch et al [5]
Which vocational rehabilitation strategies can help immune-vulnerable people, such as those with multiple sclerosis (MS), while covid remains a risk?
A US study throws up answers after researchers carried out an overview of the incidence and impact of MS in America and the 'unique' effects it has on employment.
MS is one of the most common neurological conditions in the world and causes a gradual decline in general health and functional ability.
The research recommends several vocational rehabilitation strategies to support people with MS into work and while employed, including:
- Individualised case planning
- Employer consultation
- Workplace adaptations
- Guidance from multidisciplinary health professionals
Find the full study findings and further guidance on VR for MS here: [5]
Early VR intervention
This appears to be the first paper to explore how [early intervention] VR works, for whom, and in what situations.
Jennifer A. Dunn et al. [6]
What's the impact of early VR intervention for people with newly acquired neurological conditions, such as traumatic or acquired brain injury and spinal cord injury?
Well, because "little is currently known", a New Zealand research team has been looking for the answers so they can create a programme theory to guide VR specialists.
They scoured six databases, including Cinahl, Embase, EMcare, Medline, PsychInfo and Scopus.
And from that, they were able to develop a refined programme theory that involved nine 'mechanisms', including:
- Fostering hope
- Exploring options
- Optimising self-efficacy
- Maintaining worker identity
- Engaging employer
- Flexible working
Discover more of their findings and details of their early intervention VR programme theory here: [6]
Further reading
The UK's occupational laws help to guide employers in adapting workplaces for people with disabilities. Please find out more in a Q&A with our occupational health expert, Neuro OT and Clinical Manager Vicky Baylis…
Adapting work for workers with disabilities (krysalisconsultancy.co.uk)
Neuro OT and the autistic MD: how one boss's 17-year search for answers for her mental health difficulties ended with a new mission as a workplace neurodiversity champion…
We are helping Community Interest Company GAIN to support the employment of a neurodiverse workforce within the insurance, investment, and related financial services sectors. Here's how…
GAIN - Group for Autism, Insurance, Investment and Neurodiversity (krysalisconsultancy.co.uk)
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