This article reviews the literature on vocational outcome after stroke and discusses reasons for the minimal use of vocational outcome measures in stroke rehabilitation research. A vocational function measurement tool is proposed. The vocational rehabilitation process and experience of the Young Stroke Program at New England Rehabilitation Hospital are described, and determinants of success or failure in vocational rehabilitation after stroke as described in the medical literature are reviewed. The impact of the Americans with Disabilities Act of 1990 and of changes in health care funding on vocational outcomes after stroke are discussed.
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