Return to Work After Spinal Cord Injury Is It Related to Wheelchair Capacity at Discharge from Clinical Rehabilitation?

Objectives: To describe the number of people with spinal cord injury who returned to work (RTW) 1 yr after discharge from inpatient rehabilitation and to investigate whether RTW can be predicted from wheelchair capacity at discharge from inpatient rehabilitation, after correction for confounders. Design: Prospective cohort study in which 118 subjects with spinal cord injury (age 18-65 yrs) of eight Dutch rehabilitation centers participated. Main outcome measure was RTW for at least 1 hr/wk. The outcome variables of wheelchair capacity were peak oxygen uptake, peak aerobic power output, and wheelchair skill scores (ability, performance time, and physical strain). Possible confounders were age, gender, lesion level, and lesion completeness. Where necessary, corrections were made for education level. Results: Thirty-three percent of the subjects RTW. Peak aerobic power output (persons with a 10-W higher peak aerobic power output were 1.37 times more likely to RTW), ability score (persons with a one-point higher ability score were 2.22 times more likely to RTW), and performance time (an increase, or worsening, of 1 sec on the performance time gave an odds ratio of 0.87, so persons with lower, or better, performance time scores were more likely to RTW) were significant predictors of RTW after correction for confounders and education level. Conclusions: RTW was successful in 33% of the subjects. Wheelchair capacity was independently related to RTW. Therefore, it is recommended to train wheelchair capacity in the context of RTW.