Article Details

Research Database: Article Details

Citation:  Young, A.E., & Murphy, G.C. (2009). Employment status after spinal cord injury (1992-2005): a review with implications for interpretation, evaluation, further research, and clinical practice. International Journal of Rehabilitation Research, 32 1-11.
Title:  Employment status after spinal cord injury (1992-2005): a review with implications for interpretation, evaluation, further research, and clinical practice
Authors:  Young, A.E., & Murphy, G.C.
Year:  2009
Journal/Publication:  International Journal of Rehabilitation Research
Publisher:  Wolters Kluwer Health/Lippincott Williams and Wilkins
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  Not reported
Research design:  Systematic review / meta-analysis

Structured abstract:

Background:  Advances in medical treatment has extended the life expectancy of individuals with Spinal Cord Injuries (SCI). After recovering from injury, individuals may require assistance with employment. Over the years researchers have reported on benefits work post injury in terms of a person's overall physical condition and mental fitness. Research has also shown that work
Purpose:  The aim of this paper was to review the literature on employment after SCI from 1992 to 2005.
Data collection and analysis:  Two online databases were used to identify peer-reviewed research about employment status after SCI. More than 170 articles were retrieved and assessed for relevance among those 48 met the inclusion criteria. The studies included were population studies that reported on post-injury employment characteristics. Only studies that included traumatic SCI were included in the main analysis.
Findings:  Population studies reporting on employment status post SCI were dived into geographical regions like North American, Europe, Australia, and Asia. Studies used a wide range of definitions for employment. The majority of studies were conducted in the United States (31 of 48). The employment rates varied widely, however the researchers noted that when age of data is taken into consideration and years post injury the results are more consistent. Generally, studies with data collected more than 5 years post injury reported employment rates of 30% or more. European studies indicated rates of employment that were more consistent and generally higher than rates reported in the North American studies. Studies found 31 to 56% of respondents were employed at the time of data collection. For those who were 5 more years post injury the rate of employment in European or at least Scandinavian countries was 50 to 55%. Australian rates ranged from 31 to 47%. Employment rates after SCI in Asia were not able to be determined based on the data reported. In order to determine an overall employment rate an aggregate analysis was performed. However, the studies were reviewed in advance for their valid and independent contribution to the aggregate figure. As a result of this and other reasons some studies were excluded. After the exclusions, data from 22 samples were available for analysis. This included: 10 North American, 5 European, 4 Australian and 3 Asian. Overall it was found that 36.8% of the respondents were employed at the time of data collection. A comparison of means found that employment rates were significantly lower in North American and Asia than in Europe and Australia. Significantly more individuals were employed in Europe than Australia. The researchers also found that in the majority of cases the longer the time post injury the higher the reported rate of employment. This was a trend that continued even as long as 20 years post injury. Overall, 68% of people had worked at some point in time. Reports ranged between 34 and 74% with a median of 62%.
Conclusions:  It is estimated that approximately 40% of working age individuals with SCI who are 12 months post injury are employed at any given point in time. The accuracy of this figure may be questioned due to methodological limitations. Estimating exact rates of employment is difficult. Research shows that employment is possible post SCI, more research is needed.

Disabilities served:  Spinal cord injury (SCI)
Outcomes:  Employment acquisition
Return to work
Full-time employment
Part-time employment