Piotr Tederko

Employment determinants remain a critical yet under-researched factor in the social participation and inclusion of individuals with mobility impairments who use powered mobility devices (PWSMD). This systematic review and individual participant data meta-analysis aims to evaluate employment rates and identify factors influencing employment among PWSMD users. One- and two-stage meta-analyses were conducted, assessing employment status in relation to demographic, health-related and environmental factors. Random-effects models were used to account for between-study heterogeneity. Quality assessment was performed with tools for evidence synthesis provided by Joanna Briggs Institute (JBI). The PRISMA criteria were followed in the review. A systematic search of CINAHL, Embase, Cochrane, PubMed, Scopus and Web of Science databases conducted up to February 2025 identified 19 eligible studies encompassing 443 participants. 46.6% of participants were working at higher rates associated with tertiary education, pre-existing employment, vocational rehabilitation and PWSMD use of more than 10 years. Higher employment rates were also observed in participants younger than 60 years and those with childhood onset disability. No significant correlations were observed with sex, marital status, or residential setting. Higher levels of education, longer duration of PWSMD use, younger age, pre-existing employment and participation in vocational rehabilitation are associated with an increased likelihood of employment among PWSMD users. Sex, marital status and settlement type may not have an impact on employment. Further research is needed to determine most beneficial aspects of vocational rehabilitation and to explore the relationship between disability duration and employment in specific diagnostic groups.

Introduction and objective: The Rehabilitation Definition for Research Purposes (RDRP), published in 2022 by Cochrane Rehabilitation, addresses discrepancies resulting from the multiplicity and heterogeneity of rehabilitation definitions hitherto used in the contexts of science, health, and...

Purpose: To identify correlations between demographic, health-related, environmental factors and the employment status of power wheelchair (PWC) users.Method: We retrospectively analysed semi-structured interviews with 128 participants, their assistants or family members, and the participant's provided medical records. Participants were adult PWC users who applied for grants in purchasing a new PWC for gaining or keeping employment between 2019-2021 in Mazovian Province, Poland.Results: Forty-six PWC users (35.9%) were employed while applying for the financial support programme. Fischer's Exact Test of Independence identified positive correlations between employment and education level (p < 0.001), residing in an urban area (p = 0.02), being employed before starting PWC use (p < 0.001), having vocational rehabilitation (p < 0.001), and living in a relationship (p = 0.002). There were no associations between employment status and sex, age at study entry, age at disability onset, living alone or with others, duration of PWC use, or full or part-time PWC use. Our findings indicate that PWC users are at risk of non-employment and financial hardship. This research may support policies for PWC provision that would support gainful employment. The results show that access to quality education, vocational rehabilitation, and perhaps the physical/emotional support from others in close relationships matter. These aspects should be considered in educational policies, transportation, and physical environmental accessibility for PWC users, supporting their gainful employment.

(1) Background: Despite efforts to improve access to health services, between- and within-country access inequalities remain, especially for individuals with complex disabling conditions like spinal cord injury (SCI). Persons with SCI require regular multidisciplinary follow-up care yet experience more access barriers than the general population. This study examines health system characteristics associated with access among persons with SCI across 22 countries. (2) Methods: Study data are from the International Spinal Cord Injury Survey with 12,588 participants with SCI across 22 countries. Cluster analysis was used to identify service access clusters based on reported access restrictions. The association between service access and health system characteristics (health workforce, infrastructure density, health expenditure) was determined by means of classification and regression trees. (3) Results: Unmet needs were reported by 17% of participants: lowest (10%) in Japan, Spain, and Switzerland (cluster 1) and highest (62%) in Morocco (cluster 8). The country of residence was the most important factor in facilitating access. Those reporting access restrictions were more likely to live in Morocco, to be in the lowest income decile, with multiple comorbidities (Secondary Conditions Scale (SCI-SCS) score > 29) and low functioning status (Spinal Cord Independence Measure score < 53). Those less likely to report access restriction tended to reside in all other countries except Brazil, China, Malaysia, Morocco, Poland, South Africa, and South Korea and have fewer comorbidities (SCI-SCS < 23). (4) Conclusions: The country of residence was the most important factor in facilitating health service access. Following the country of residence, higher income and better health were the most important facilitators of service access. Health service availability and affordability were reported as the most frequent health access barriers.

To determine the association between the strength of primary care and perceived access to follow-up care services among persons with chronic spinal cord injury (SCI).Data analysis of the Internatio...

Purpose: To determine the relationships between impact of secondary health conditions (SHCs), treatment of SHCs, and life satisfaction (LS) following spinal cord injury (SCI) across 21 countries. Hypotheses were as follows: (1) Persons with SCI and fewer SHCs report higher LS and (2) Persons who receive treatment for SHCs report higher LS than those who do not receive treatment. Methods: Cross-sectional survey, including 10,499 persons with traumatic or non-traumatic SCI aged 18 years or older and living in the community. To assess SHCs, 14 items adapted from the SCI-Secondary Conditions Scale were used (range 1–5). SHCs index was calculated as the mean of all 14 items. LS was assessed using a selection of 5 items from the World Health Organization Quality of Life Assessment. LS index was calculated as the mean of these 5 items. Results: South Korea, Germany, and Poland exhibited the highest (2.40–2.93) and Brazil, China, and Thailand the lowest (1.79–1.90) impact of SHCs. Indexes for LS and SHCs were inversely correlated (– 0.418; p < 0.001). Mixed Model Analysis showed that the fixed effect (key predictors of the study) of SHCs index (p < 0.001) and the positive interaction between SHCs index and treatment (p = 0.002) were significant determinants of LS. Conclusion: Persons with SCI across the world are more likely to perceive better LS if they experience fewer SHCs and receive treatment for SHCs, in comparison to those who do not. Prevention and treatment of SHCs following SCI should be a high priority in order to improve the lived experience and enhance LS.

Background Occipital pressure sores (OPS) are complications of the use of cervical collars. Prophylaxis of OPS in patients after cervical spinal surgery (CCS) appears to be neglected. Material and methods Cochrane Central, EMBASE, PubMed, SCOPUS, and Web of Science databases were searched...

Introduction and objective. Spinal cord injury (SCI), which disrupts motor, sensory and autonomic functions, causes significant changes in the functioning of an individual. It is believed that most of the conditions secondary to SCI, i.e. osteoporosis, spasticity or cardiopulmonary diseases, are associated with immobility. The aim of the study is to assess the adherence to prescriptions of therapeutic exercises (APTE) in patients with SCI after acute phases of rehabilitation. Materials and methods. The criterionfor APTE recognition was the performance at least twice a week for a minimum of 30 minutes of active exercises with resistance, and exercises maintaining the range of movement of the joints The research tools were own questionnaire and the WHOQOL-BREF scale. Results. 46 subjects (63.9%) met the APTE criteria. The most frequent place for performing the exercises was the subject's home with 43 subjects (93.5%) with APTE performed the exercises in their homes. 17 subjects (36.9%) with APTE performed exercises during stays at various rehabilitation centres. The main cause for the lack of APTE was the limited availability of facilities considered necessary by the respondents to adhere to the instructions. In statistical analysis, the level of neurological injury correlated with meeting the APTE criteria. It was discovered that a subjective assessment of the exercise dose correlated with the place where the exercises were performed, but did not correlate with meeting the APTE criteria. Conclusions. The basic place for performing exercises (as instructed in hospital) was the subject's home. Limited access to reimbursed environmental therapy resulted in an increased cost of exercises supervised by commercially-employed physiotherapists. The current gaps in the system of supervision and counselling of subjects post-SCI necessitate changes in the Polish health care system.