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Person-centered work rehabilitation for persons with neurological disorders: An innovative use of participatory approaches in designing and evaluating a complex intervention

The overall aim of this project is to design and evaluate a person-centered RtW rehabilitation program for adults in working age with neurological disorders, such as stroke, spinal cord injury, and multiple sclerosis.The design will be based on a participatory approach combining an analysis of qualitative (including visual) and quantitative data through a progression of phases in the project.

The single most important non-medical outcome of rehabilitation for working-age adults with neurological disorders such as stroke (CVA), spinal cord injury (SCI), and multiple sclerosis (MS) is return to work (RtW). Yet, more than a third of persons under 65 years of age do not go back to work after stroke, a majority of persons with a new SCI do not work post-injury, and the proportion of people with MS working full-time/part-time is low but varies from 23% to 59%.

Rehabilitation focusing on RtW in Sweden, and in this project, involves several agents whose objective is to enable people with disabilities in RtW, although in some instances this can involve cutting down on work.


This project builds on the medical research council (MRC) guidance framework for developing and evaluating complex interventions, which are “inter­ventions that contain several interacting components, but have other characteristics that evaluators should take into account” (p.979); characteristics such as behaviors required by those delivering and receiving the intervention, organizational levels targeted by the intervention, as well as number and variability of outcomes.

The framework consists of four elements: a) development, b) feasibility and piloting, c) evaluation, and d) implementation of an intervention.

Financial support

  • Doctoral School in Health Care Sciences at Karolinska Institutet (x 3 projects)
  • Norrbacka Eugenia Foundation
  • Neuro Sweden
  • Uppsala Läns Ländsting
  • Gävleborgs Länslandsting
  • Regionala Forskningsrådet Uppsala Örebro
  • and KI Funds at Karolinska Insititutet.


Eric Asaba (PI - Spinal Cord Injury projects)

Gunilla Eriksson (PI – Stroke projects)

Sverker Johansson (PI – Multiple Sclerosis projects)


Susanne Guidetti, Therese Hellman, Ulla Johansson, Birgitta Bernsprång, Jan Hillert, Lars Lindholm, and Åke Seiger


Bergmark, L., Westgren, N., & Asaba, E. (2011). Returning to work after spinal cord injury: Exploring young adults' early expectations and experience. Disability & Rehabilitation. 33(25-26), 2553-2558.