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Return to Work after Spinal Cord Injury: A Review of Recent Research

Article Summary

Yasuda, Wehman, Targett, Cifu, & West (2002) reviewed recent literature on employment outcomes for individuals with Spinal Cord Injury (SCI), including the effects of demographics variables, occupational characteristics, workplace accommodations, quality of life, physical functional limitations, and other variables, and recommended future research directions to enhance employment opportunities for individuals with SCI.

Yasuda et al. (2002) report that of individuals who returned to work post-injury, more individuals started at a new employer rather than returning to work with their former employer. The individuals that did return to their old employer returned to work much earlier than individuals who found new employment. In addition, if the individual was employed at the time of the injury, there was a greater probability of post-injury employment, but this was limited to the first few years post-injury.

Yasuda and her colleagues report that although gender did not seem to be significantly associated with return to work, there was a significant relationship between gender and type of work. Yasuda et al. reports, "Men were twice as likely as women to be in paid employment, whereas women were more likely to engage in a non-paid productive role which include volunteers, full and part-time students, and homemakers." Other factors such as race, age, and education were also significantly associated with return to work. Age at the time of injury was significantly associated with return to work and is reported by Yasuda et al. to be the most apparent predictor of return to work. Individuals injured before the age of 18 have the highest employment rate (69%) compared to individuals injured after age 45, which had an employment rate of only 9%.

A positive relationship was reported between life satisfaction and adjustment after SCI and employment status. Individuals that were employed post-injury had fewer medical treatments, completed more years of education, were more satisfied with their lives, and rated their overall adjustment higher than individuals who were not employed.

Yasuda et al. report, "Since employment is important in our society not just in terms of financial security but also for self-esteem, independence, social relationships, self-worth, and personal identity, it becomes critical to provide ongoing assistance in addition to effective rehabilitation programs. This would enable persons with SCI to return to work and as a result enhance their quality of life."

Yasuda and colleagues believe there is a need to explore knowledge and use of rights and remedies of individuals with SCI to self-advocate for employment, accommodations as well as reasons that individuals with SCI self-report that they choose not to attempt to return to work. Recent legislation has also been passed such as the Ticket to Work Incentives Improvement Act of 1999 (TWIIA) and the State Partnership Systems Change Initiative (SPI) to help individuals work and retain benefits, ease the transition to self-sufficiency, alleviate obstacles, and promote employment of individuals with SCI as well as other disabilities. As legislative initiatives unfold, Yasuda et al. believe researchers should examine the effects on motivation to return to work following SCI and other disabilities to determine long-term workforce participation. Yasuda et al. conclude, "Through these initiatives, effective supports that would benefit individuals with SCI returning to work may be determined."


Yasuda, S., Wehman, P., Targett, P., Cifu, D. X., West, M. (2002). Return to work after spinal cord injury: A review of recent research. NeuroRehabilitation, 17(3), 177-186.