International Comparison of Vocational Rehabilitation for Persons With Spinal Cord Injury: Systems, Practices, and Barriers

Top Spinal Cord Inj Rehabil, 2020 · DOI: 10.1310/sci2601-21 · Published: January 1, 2020

Spinal Cord Injury Occupational Health Rehabilitation

Simple Explanation

This study explores vocational rehabilitation (VR) systems, practices, and barriers for individuals with spinal cord injury or disease (SCI/D) across different countries. Researchers surveyed medical and VR experts from SCI/D rehabilitation centers in seven countries to understand the variations in VR approaches and the obstacles to return to work. The study found that while VR systems and social security services differ significantly among centers and countries, the barriers encountered during VR, such as patient fatigue and lack of confidence, are largely similar.

Study Duration

April 2017 and August 2017

Participants

Medical and VR experts from SCI/D rehabilitation centers in seven countries

Evidence Level

Descriptive cross-sectional study

Key Findings

1
VR systems and practices differ significantly across centers, particularly in terms of timing, location, and funding, but the barriers experienced are largely consistent.
2
The age and preinjury occupation of the patient influence the content of VR in some countries, with older individuals in manual jobs receiving different VR approaches.
3
Common barriers to VR include patient fatigue, lack of confidence in their ability to work, inadequate transportation/accessibility, and gaps in the team’s knowledge of business/legal aspects.

Research Summary

This cross-sectional study compared VR systems and practices for individuals with SCI/D across seven countries, revealing significant differences in the timing, location, and funding of VR programs. The study identified several common barriers to VR, including patient-related factors like fatigue and confidence, as well as system-related factors like transportation and team knowledge. The findings highlight the importance of considering the variability in VR systems and social security services when comparing study results and suggest that addressing modifiable barriers could improve work participation outcomes for individuals with SCI/D.

Practical Implications

Tailored VR Programs

VR programs should be tailored to the individual's age, pre-injury occupation, and specific needs to optimize return-to-work outcomes.

Address Common Barriers

Rehabilitation centers and policymakers should focus on addressing common barriers to VR, such as patient fatigue, transportation issues, and lack of confidence, to improve work participation.

Team Education and Knowledge

Invest in the education and training of VR teams to ensure they have adequate knowledge of business/legal aspects and can effectively support individuals with SCI/D in their return to work.

Study Limitations

1
Selection bias due to the selection of participating centers based on previous collaborations.
2
Limited generalizability as the participating countries were high income and western countries.
3
The two case examples did not fully represent the SCI/D population as incomplete SCI/D and paraplegia are not mentioned.

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