Return to work five years after spinal cord injury inpatient rehabilitation: is it related to wheelchair capacity at discharge?

OBJECTIVE To describe the proportion of people with spinal cord injury who returned to work 5 years after discharge from inpatient rehabilitation, and to investigate whether return to work is related to wheelchair capacity at discharge from inpatient rehabilitation. DESIGN Multi-centre prospective cohort study. SUBJECTS A total of 103 participants with acute spinal cord injury at 8 Dutch rehabilitation centres, specialized in the rehabilitation of spinal cord injury. All participants were in paid employment before injury. METHODS Main outcome measure was return to work for at least 1 h per week. The independent variables of wheelchair capacity were peak oxygen uptake (VO2peak), peak aerobic power output (POpeak), and wheelchair skill scores (ability, performance time, and physical strain). Possible confounders were age, gender, lesion level and lesion completeness, and educational level. RESULTS The proportion of participants who returned to work was 44.7%. After correction for the confounders, POpeak (p=0.028), ability score (p=0.022), performance time (p=0.019) and physical strain score (p=0.038) were significantly associated with return to work. VO2peak was not significantly associated with return to work. CONCLUSION More than 40% of the participants were able to return to paid work within 5 years after discharge from inpatient rehabilitation. Return to work was related to wheelchair capacity at discharge. It is recommended to train wheelchair capacity during rehabilitation in the context of return to work, since the association with return to work is another benefit of the training of wheelchair capacity in addition to the improvement of mobility and functional independency.