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Final Program


Final Congress Guide

Clinical Sciences/Health Conditions

300 Section - Sex differences in return to work after stroke: A systematic review and meta-analysis

Wednesday, May 20, 2026
6:00 PM - 7:30 PM PT

    Presenting Author/Autor expositor(s)

  • ED

    Emily T. Domerchie, MD

    Resident Physician
    University of Toronto
    Toronto, Ontario, Canada

    • Co-Author/Coautor(s)

  • SM

    Shannon MacDonald, MD

    Physician
    University of Toronto
    Toronto, Ontario, Canada

  • MA

    Mohammad Alavinia, PhD

    Biostatistician
    University Health Network
    Toronto, Ontario, Canada

  • Robert W. Teasell, MD, FRCPC

    Professor
    Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., Lawson Research Institute at St. Joseph’s Health Care London
    London, Ontario, Canada

  • AT

    Ada Tang, PhD

    Professor
    McMaster University
    Hamilton, Ontario, Canada

  • BS

    Brodie Sakakibara, PhD

    Associate Professor
    University of British Columbia
    Vancouver, British Columbia, Canada

  • AQ

    Adria Quigley, PhD

    Assistant Professor
    Dalhousie University
    Halifax, Nova Scotia, Canada

Objectives : The incidence of stroke in working-age individuals is increasing globally. Return-to-work is an important indicator of post-stroke recovery, impacting patients’ quality of life, self-identity, and financial stability. Currently, there is a lack of consensus regarding the role of sex in predicting return-to-work. The primary aim of this review was to determine the odds of return-to-work after stroke in males compared to females. Secondary objectives were to determine whether sex-differences varied by continent or follow-up interval.

Design:

Following PRISMA guidelines, MEDLINE, Embase, and CINAHL were systematically searched from their inception to December 2024 for English-language cross-sectional, cohort, and registry studies investigating return-to-work after ischemic or hemorrhagic stroke. Included studies reported the proportion of males and females that returned to part- or full-time work. Meta-analysis was conducted using the odds ratio (OR) of return-to-work for males compared to females.

Results: Forty-eight studies were included involving 83,196 previously employed participants recruited from varied healthcare settings with return-to-work assessed between one month and five years post-stroke. Random-effects meta-analysis of 43 studies (n=54,061 participants) did not demonstrated an association between male sex and return-to-work (OR 1.14; 95% CI 0.99-1.31). After excluding nine high-risk-of-bias studies (n=42,129 participants), a random-effects meta-analysis demonstrated a significant positive association between male sex and return-to-work (OR 1.20; 95% CI 1.05-1.37). Sub-analysis by continent demonstrated a significant association between male sex and return-to-work only for studies conducted in Asia (1.39; 95% CI 1.12-1.73). No sex difference was found by follow-up interval. 

Conclusion:

Male sex may be associated with higher odds of return-to-work after stroke. However, this sex difference appears to be influenced by geographic region. These findings highlight the need for further investigation into the complex factors contributing to sex disparities in post-stroke return-to-work outcomes.