Stroke is a leading cause of disability worldwide, with significant consequences for young adults, including functional limitations, reduced work capacity, and challenges in rehabilitation adherence. Although the impact of stroke on older populations is well-documented, studies on young stroke survivors remain limited, particularly regarding barriers to rehabilitation and return to work. Identifying the factors influencing functionality, work ability, and rehabilitation participation is important for improving post-stroke outcomes in this population.

This study aimed to (1) assess functionality and work ability among young adults post-stroke, (2) evaluate perceived barriers to rehabilitation, and (3) examine the relationship between functional status, work capacity, and rehabilitation barriers.

A cross-sectional study was conducted with 50 young adult stroke survivors (ages 18–65). Functional assessments included the National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), Barthel Index (BI), and Stroke Impact Scale (SIS). Work ability was measured using the Work Ability Index (WAI), and barriers to rehabilitation were assessed using the Cardiac Rehabilitation Barriers Scale (CRBS). Correlation analyses explored associations between functionality, work ability, and rehabilitation barriers.

Participants exhibited moderate functional impairment (median NIHSS: 6, IQR: 4; BI: 88, IQR: 32; mRS: 2, IQR: 1), with SIS subdomains indicating significant mobility and hand function deficits. Work ability was generally low (median WAI: 10, IQR: 9), with a strong positive correlation between higher functional status and work ability (e.g., BI and WAI, r = 0.56, p < 0.001). Rehabilitation barriers were prevalent, particularly in perceived needs and accessibility. Higher CRBS scores were associated with lower functional status and work ability, suggesting that socioeconomic and logistical factors significantly impact rehabilitation adherence.

Young stroke survivors face substantial functional limitations and work restrictions, compounded by socioeconomic and accessibility barriers to rehabilitation. Addressing these challenges through targeted rehabilitation programs and improved access to services may enhance functional outcomes and work reintegration.

These findings highlight the need for integrated post-stroke rehabilitation strategies that consider functionality, work capacity, and rehabilitation barriers. Policymakers and healthcare providers should focus on reducing structural and socioeconomic obstacles to optimize recovery and reintegration into professional life.