Welcome to SCIRE Professional

Work and Employment


Systematic Review

Personal Factors Associated with Employment Post-SCI

Environmental Factors Associated with Employment Post-SCI

Interventions for Enhancing Employment Post-SCI

Escorpizo R, Smith EM, Finger ME, Miller WC (2018). Work and Employment Following Spinal Cord Injury. In: Eng JJ, Teasell RW, Miller WC, Wolfe DL, Townson AF, Hsieh JTC, Connolly SJ, Noonan VK, Loh E, McIntyre A, Sproule S, Querée M, Benton B editors. Spinal Cord Injury Rehabilitation Evidence. Version 6.0. Vancouver: p 1- 35.

We would like to acknowledge previous contributors: Luc Noreau, Erik von Elm, and Amira Tawashy.

Key Points

  • Non-modifiable personal characteristics such as: being male and Caucasian, younger at injury; with a longer duration of injury (20-30 years); with higher pre-injury education; being less severely injured; and being employed at injury in a low-intensity job increase the likelihood of employment post-SCI.
  • Modifiable personal characteristics such as: being highly educated post-SCI; limiting the occurrence of health complications; having a higher level of independence (including wheelchair skills); and having the trait of valuing work can increase the likelihood of employment post-SCI.
  • Environmental facilitators include having access to various assistive devices, using transportation independently, having social support (including being married), and having the possibilities of job accommodation including reduced work hours.
  • Environmental barriers to employment are social or physical and include financial disincentives, discrimination associated to negative attitudes toward people with disabilities and difficulties with physical access to workplace.
  • A single environmental factor can be perceived either as a barrier or a facilitator to employment based on its presence/absence in one’s environment and its impact on effective returning to work.
  • People with SCI may benefit from vocational rehabilitation in the process of job placement and work reintegration.
  • There is a lack of high quality research in vocational (re) training. Consequently, conclusions are mostly based on evidence from observational studies or case studies.
  • Continuous support to the employee and employer before and after vocational placement may lead to a successful return to work and job retention.