Employment status after spinal cord injury (1992-2005): a review with implications for interpretation, evaluation, further research, and clinical practice.

The purpose of this study is to review the research conducted on the topic of employment status after spinal cord injury that was published between 1992 and 2005. This study follows on from an earlier review that focused on papers published between 1976 and 1991. The current study extends the earlier review by reporting an aggregate employment rate for those at least 12 months postinjury, separating rates for those living in different geographical areas (i.e. North America, Europe, Australia, and Asia), and reporting rates at various times of postinjury (rates from a minimum of 1 year postinjury, through rates at a follow-up of more than 20 years postinjury). As was found in the earlier review, a diversity of employment rates was observed; however, this diversity was reduced when studies of similar design were compared. Results indicate that although it may take some time to be realized, there is significant vocational potential amongst those with spinal cord injury. On the basis of the results of the review, it was concluded that approximately 40% of working age people greater than 12 months postinjury are employed at the time of data collection, with this rate increasing as the postinjury time increases, peaking at 10-12 years postinjury. Significant differences in employment rates depending on the geographical location of the studied population were observed. Recommendations for further research are made and implications for service provision to individuals with disabling injuries are discussed.