Work and SCI: a pilot randomized controlled study of an online resource for job-seekers with spinal cord dysfunction

Abstract

Study design: Prospective, parallel randomized controlled trial (RCT) Objectives: To test the preliminary effects of an online resource targeted to job-seekers with spinal cord injury or disorder (SCI/D) and to determine the feasibility of proceeding to a full-scale RCT. Setting: Community cohort in Australia. Methods: Forty-eight adults (M = 42 years, SD = 10.95, 27 male) were randomized to receive 4-weeks access to the 'Work and SCI' resource (n = 25) or to a wait-list control group (n = 23). The 'Work and SCI' intervention involved six stand-alone learning modules which provided job-searching and career planning information through text, videos and interactive activities. Self-report measures were administered at baseline and 4-weeks post: Job Procurement Self-Efficacy Scale (JSES), Life Orientation Test-Revised (LOT-R) and Patient Health Questionnaire-9 (PHQ-9). Results: Online usage data identified high uptake of the 'Work and SCI' resource, although study attrition was problematic. Intention-to-treat analyses failed to reach statistical significance whereas completer data revealed a significant interaction effect for optimism (LOT-R). Conclusion: Further research to develop and enhance 'Work and SCI' is indicated. Remediable strategies to optimize recruitment and statistical power in a future definitive RCT are discussed. Sponsorship: This project was funded by the auDA Foundation (project. 16019)

Substantiating Clinical Effectiveness and Potential Barriers to the Widespread Implementation of Spinal Cord Injury Telerehabilitation: A Systematic Review and Qualitative Synthesis of Randomized Trials in the Recent Past Decade

“…The following is a summary of the characteristics of the selected studies included in this review. 6,11,[22][23][24][25][26][27][28][29][30][31] The affiliated institution, country of origin, study title, study objectives, journals in which they were published, along with digital object identifier numbers and date of articles' first submission were extracted. After agreement by coauthors, studies were included, following independent search and screening efforts without the assistance of a librarian.…”

“…21,25 Majority did not use ASIA scale classification, whereas some labeled participants as ''tetraplegia'' ver-sus ''paraplegia'' without detailed neurological levels. 11,22,24,27,28,30,31 Six studies reported completeness or incompleteness of injury. 11,22,24,27,30,31 One study that included MS participants reported only neurological levels of injury for its SCI participants.…”

“…11,22,24,27,28,30,31 Six studies reported completeness or incompleteness of injury. 11,22,24,27,30,31 One study that included MS participants reported only neurological levels of injury for its SCI participants. 32 Two studies, which included disabilities of varying disorders (MS, CP, stroke, amputees, and lupus), did not specify neurological levels of injury nor ASIA classification.…”

“…26,31 The remaining six studies did not report comorbidities of participants. 6,24,[27][28][29][30] Study methods. The settings for conducting the intervention were in the participants' home for all studies (some studies indicated ''community'' as a designated remote location and that was considered as ''home'').…”

“…In contrast, one study was conducted in a laboratorysimulated home setting. 23 Geographically, studies were conducted in various countries including the United States, 26,[27][28][29]32 Canada, 24,26 Australia, 22,24,30 United Kingdom, 25,27 Bangladesh, 21 India, 23 and China. 31 Various methods of data collection were reported, including telephone interviews and/or in combination with written questionnaires.…”