Vocational rehabilitation interventions in spinal cord injury: a scoping review

Abstract

Introduction: Spinal cord injury can significantly affect participation in meaningful occupations such as work. Return to work is influenced by physical, emotional, social, and contextual factors, highlighting the need for interdisciplinary interventions. However, there is no consensus on the most effective modalities. Objective: This study aims to determine the available evidence on interventions targeting return to work among people with spinal cord injury. Method: A scoping review was conducted in February 2025, searching the PubMed, Scopus, and Web of Science databases. Observational and experimental studies, as well as systematic reviews, published between 2010 and 2024 in Spanish, Portuguese, or English were included. A snowball search complemented the process. Intervention strategies, geographic distribution, and study contexts were analyzed, along with methodological limitations and knowledge gaps. Results: Ten studies were included: nine observational and one experimental. Various vocational rehabilitation modalities were identified, with diverse approaches depending on the country and healthcare system. Strategies ranged from structured programs to one-off interventions without continuity or standardized follow-up. Conclusion: The scarcity of studies on vocational rehabilitation, together with significant methodological limitations, reveals a gap in the literature. These findings underscore the need to develop more robust, comparable, and contextsensitive research to guide the implementation of effective practices promoting return to work.