Participation in Organized Sports Is Positively Associated with Employment in Adults with Spinal Cord Injury

In the United States, the Americans with Disabilities Act of 1990 exists to protect the employment rights of individuals with disabilities, to include nondiscrimination in hiring and promotions as well as access to reasonable accommodation for full accessibility of the workplace.1 Despite this, the rate of employment for adults with spinal cord injury (SCI) remains low as compared with that for the general population. The data from the 2010 Annual Report for the SCI Model Systems reveal that, 5 yrs after injury, approximately 20.7% of adults with SCI were competitively employed. This proportion peaks at 36% for those who are 25 yrs postinjury.2 These data are corroborated by the data retrieved from the United States Census Bureau revealing that, in 2008, a total of 28.7% of adults aged 21–64 yrs and with self-report of ambulatory disability were competitively employed.3 In contrast, the data from the United States Department of Labor, Bureau of Labor Statistics, reveal a civilian unemployment rate of 4.9%–10% for the general population older than 16 yrs throughout the years4 2008–2010. Although it is unknown whether these reports define employment uniformly, these data are suggestive of the ongoing disparity in rates of employment for adults with SCI when compared with the general population. It is commonly accepted that meaningful employment is a cornerstone of achieving self-efficacy and a sense of purpose into adulthood. Employment after SCI has been shown to be a critical component of life satisfaction, subjectively positive quality-oflife,5–10 and financial independence.11–13 Given this, much emphasis has been placed on the identification of social and demographic factors, in addition to targeted rehabilitation strategies, that may promote employment after SCI. Previous studies uniformly agree on factors such as level of education and functional independence as those positively correlated with employment.7,14–17 In addition, independent use of public or private transportation,7 white race,18,19 fewer medical complications,7 lack of concomitant brain injury,16 and inherently high motivation to work20 have also shown positive correlation. Of interest, neurologic level of injury and ambulatory status have shown mixed results in their association.14,16 In the ongoing effort to identify rehabilitation strategies that may stimulate employment after SCI, organized sports has come under investigation. Studies addressing the relationship between organized sports and employment have thus far shown mixed results. A German study focused on the effect of physical exercise on quality-of-life for adults with SCI reported that individuals involved in sports were also more likely to be employed.8 Countering this, Taseimski et al.21 found that, although both rates of participation in sports and employment decreased significantly after SCI, there was no association between the two. Similarly, Foreman et al.,22 in a study of the demographic and psychological factors that may influence sport participation, found no association between sports and employment status; however, the study did show that those with higher income were more likely to participate. Although several studies have linked fitness-related parameters to employment such as wheelchair mobility, body composition, power output, functional independence (as measured by the Functional Independence Measure), number of medical complications, and perceived exertion,23–25 few have directly investigated the association between organized sports and employment. Given these conflicting results and an overall paucity of information, this study aimed to determine the relationship between participation in organized sports and employment in a United States–based sample of adults with SCI.