Interventions for improving employment outcomes among individuals with spinal cord injury: A systematic review

Abstract

databases was performed on 31 December 2013. To be included in the review, studies needed to investigate interventions among individuals with SCI where employment was an outcome. Exclusion criteria include (i) reviews, (ii) studies not published in English and (iii) non-peer reviewed publications. Results: Fourteen studies met the inclusion criteria, two were randomized controlled trials. The strongest evidence finds that supported employment can improve employment outcomes among individuals with SCI. The use of service dogs has also been shown to improve employment outcomes. The remaining 12 studies are observational and predominantly focus on vocational rehabilitation programs. Conclusion: There is a dearth of high-quality intervention research that targets employment outcomes in individuals with SCI. Consequently, conclusions are mostly based on evidence from observational studies. Vocational rehabilitation programs are the primary focus of this evidence, but conclusions may be confounded, as individuals may be self-selecting for these programs. Additional randomized trials on employment interventions are needed to overcome these limitations. Studies should aim to identify which components of these programs have the greatest influence on employment outcomes.

Hospital- and community-based interventions enhancing (re)employment for people with spinal cord injury: a systematic review

“…A systematic review describing interventions improving employment outcome in SCI was recently published by Trenaman et al 30 This review has a similar conclusion as ours stating a profound lack of high level evidence studies focusing on interventions aiming at employment post SCI. However, the objective of the review by Trenaman et al differed from our review as they primarly aimed at evaluating the intervention itself, whereas in our study we aimed at reporting the effect of the intervention on employment rate and duration of employment.…”

Early Access to Vocational Rehabilitation for Inpatients with Spinal Cord Injury: A Qualitative Study of Patients' Perceptions

“…aimed at improving employment outcomes for this population, 7 with only one randomized controlled trial of vocational intervention among individuals with SCI to date. 8 This trial found that an outpatient individual placement and support model of vocational rehabilitation (VR) for American Veterans with chronic SCI was more likely to result in competitive employment at 1 and 2 years compared with usual treatment.…”

Return to Work Practices and Research with Spinal Cord Injury: An Australian Perspective

“…Studies of post-injury interventions for those living with SCI are limited (see Trenaman, Miller, Escorpizo et al, 2014) and, where present, have tended to focus on the pre-vocational stage. This includes studies that have examined interventions to enhance resilient coping with SCI rather than RTW outcomes per se.…”

“…However, the incremental benefits of RTW rehabilitation offered during the in-patient SCI rehabilitation phase compared with vocational interventions offered in community are still largely unknown, although results from one large, state-wide pilot study in New South Wales are promising in terms of enhanced postinjury vocational achievements (see Middleton et al, 2014). While experimental designs would provide strong evidence for specific RTW interventions (see Elliot & Kennedy, 2004;Trenaman et al, 2014), it is difficult to maintain comparability of groups over time given the medical complexities of SCI, including recurrent or secondary health problems seen in this population. Studies would therefore always need to address effects on RTW outcomes explained by secondary conditions following SCI, as such conditions limit labour force participation (Craig & Nicholson Perry, 2014).…”

“…A more general problem with research in the field is the scarcity of high quality experimental studies of interventions aiming to enhance post-injury vocational achievements among those living with SCI. Trenaman et al (2014) attempted to conduct a systematic review on the topic and could locate only two relevant experimental studies.…”