Key Points

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  • 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 dearth 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.