title: Return to work following spinal cord injury: a review.
abstract: OBJECTIVE
  To review literature on return to work (RTW) and employment in persons with spinal cord injury (SCI), and present employment rates, factors influencing employment, and interventions aimed at helping people with SCI to obtain and sustain productive work.
  
  
  METHODS
  A systematic review for 2000 - 2006 was carried out in PubMed/Medline, AMED, (ISI) Web of Science, EMBASE, CINAHL, PsycInfo and Sociological abstracts database. The keywords 'spinal cord injuries', 'spinal cord disorder', 'spinal cord lesion' or 'spinal cord disease' were cross-indexed with 'employment', 'return to work', 'occupation' or 'vocational'.
  
  
  RESULTS
  Out of approximately 270 hits, 110 references were used, plus 13 more found elsewhere. Among individuals with SCI working at the time of injury 21 - 67% returned to work after injury. RTW was higher in persons injured at a younger age, had less severe injuries and higher functional independence. Employment rate improved with time after SCI. Persons with SCI employed ranged from 11.5% to 74%. Individuals who sustained SCI during childhood or adolescence had higher adult employment rates. Most common reported barriers to employment were problems with transportation, health and physical limitations, lack of work experience, education or training, physical or architectural barriers, discrimination by employers, and loss of benefits. Individuals with SCI discontinue working at younger age.
  
  
  CONCLUSIONS
  This review confirmed low employment rates after SCI. Future research should explore interventions aimed at helping people with SCI to obtain and sustain productive work.
authors.affiliation: Department of Research, Sunnaas Rehabilitation Hospital, 1450 Nesoddtangen, Norway. ingeborg.lidal@sunnaas.no
authors.forename: Ingeborg Beate
authors.initials: IB
authors.lastname: Lidal
authors.forename: Tuan Khai
authors.initials: TK
authors.lastname: Huynh
authors.forename: Fin
authors.initials: F
authors.lastname: Biering-Sørensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000145:classification / Q000523:psychology / Q000534:rehabilitation; D013315:Stress, Psychological / Q000209:etiology; D013997:Time Factors; D014478:Unemployment / Q000523:psychology / Q000706:statistics & numerical data