{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:59:39Z","timestamp":1787029179428,"version":"build-2736575974"},"reference-count":36,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NeuroSci"],"abstract":"<jats:p>This study investigates employment rates and their determinants among individuals with spinal cord injury (SCI) in Romania using data from the Romanian National Spinal Cord Injury Survey (RO-InSCI), part of the International Spinal Cord Injury (InSCI) Community Survey. The cross-sectional study included 215 adults with traumatic or non-traumatic SCI living in the community. Participants were recruited through rehabilitation hospitals and patient organizations. Employment status, demographic characteristics, and injury-related factors were assessed. The observed employment rate was 25.35%, with a 39.45% employment gap compared to the general population. Barriers to employment included health status, disability, inadequate transport, and insufficient access to infrastructure, particularly for those with traumatic SCI. Vocational rehabilitation participation was low (18.7%), despite a strong desire to return to work (82% for traumatic SCI, 61.1% for non-traumatic SCI). Before injury, participants were primarily employed in elementary occupations, with higher rates among those with paraplegia. The findings highlight the need for targeted interventions, inclusive labor market policies, and improved accessibility to vocational rehabilitation to support workforce reintegration and address the specific needs of individuals with SCI in Romania.<\/jats:p>","DOI":"10.3390\/neurosci6010010","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T04:36:51Z","timestamp":1738557411000},"page":"10","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Employment and Its Determinants for Spinal Cord Injury Population in Romania"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0645-4911","authenticated-orcid":false,"given":"Camelia Florentina","family":"Lascu","sequence":"first","affiliation":[{"name":"Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiana","family":"Popa","sequence":"additional","affiliation":[{"name":"B\u0103ile Felix Medical Rehabilitation Hospital, 417500 B\u0103ile Felix, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camelia Liana","family":"Buha\u0219","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"},{"name":"Morphological Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"},{"name":"County Clinical Emergency Hospital of Oradea, 410169 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5960-9043","authenticated-orcid":false,"given":"Florica","family":"Voi\u0163\u0103-Mekere\u015f","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"},{"name":"Morphological Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"},{"name":"County Clinical Emergency Hospital of Oradea, 410169 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florina Ligia","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matei","family":"Teodorescu","sequence":"additional","affiliation":[{"name":"Rehabilitation Department, Elias Emergency Hospital, 011461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgiana Albina","family":"C\u0103i\u021b\u0103","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"},{"name":"County Clinical Emergency Hospital of Oradea, 410169 Oradea, Romania"},{"name":"Surgical Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gheorghe","family":"Szilagyi","sequence":"additional","affiliation":[{"name":"County Clinical Emergency Hospital of Oradea, 410169 Oradea, Romania"},{"name":"Surgical Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrada Florina","family":"Schwarz-Madar","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"},{"name":"Morphological Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirela Elena","family":"Bodea","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u0103lin Tudor","family":"Hozan","sequence":"additional","affiliation":[{"name":"Surgical Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,1]]},"reference":[{"key":"ref_1","unstructured":"(2025, January 09). Spinal Cord Injury. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/spinal-cord-injury."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e142","DOI":"10.1016\/j.wneu.2017.12.008","article-title":"Traumatic and Nontraumatic Spinal Cord Injuries","volume":"111","author":"Ge","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_3","unstructured":"(2025, January 09). Sickness, Disability and Work: Breaking the Barriers|OECD. Available online: https:\/\/www.oecd.org\/en\/publications\/sickness-disability-and-work-breaking-the-barriers_9789264088856-en.html."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1038\/sc.2011.12","article-title":"ISCoS-WHO Collaboration. International Perspectives of Spinal Cord Injury (IPSCI) Report","volume":"49","author":"Bickenbach","year":"2011","journal-title":"Spinal Cord"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1179\/2045772315Y.0000000031","article-title":"Modifiable and Non-Modifiable Factors Associated with Employment Outcomes Following Spinal Cord Injury: A Systematic Review","volume":"38","author":"Trenaman","year":"2015","journal-title":"J. Spinal Cord Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/MRR.0b013e32831c8b19","article-title":"Employment Status after Spinal Cord Injury (1992\u20132005): A Review with Implications for Interpretation, Evaluation, Further Research, and Clinical Practice","volume":"32","author":"Young","year":"2009","journal-title":"Int. J. Rehabil. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"80","DOI":"10.51847\/hT5JIp60UC","article-title":"Epidemiological Study on Spinal Cord Injuries in a Hospital from North-West of Romania","volume":"14","author":"Fodor","year":"2023","journal-title":"Pharmacophore"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"58","DOI":"10.51847\/npqdV19MYv","article-title":"Systematic Review of the Effect of Aging on Health Costs","volume":"14","author":"Manole","year":"2023","journal-title":"Arch. Pharm. Pract."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1038\/s41393-023-00876-4","article-title":"Labour Market Participation after Spinal Cord Injury. A Register-Based Cohort Study","volume":"61","author":"Halvorsen","year":"2023","journal-title":"Spinal Cord"},{"key":"ref_10","first-page":"15","article-title":"The Place of Our Paraplegic Fellow-Man in Society: A Survey on 2000 Patients","volume":"30","author":"Guttmann","year":"1959","journal-title":"Spinal Cord"},{"key":"ref_11","unstructured":"World Health Organization (2001). International Classification of Functioning Disability and Health (ICF), World Health Organization."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1038\/sj.sc.3100948","article-title":"Return to Work after Spinal Cord Injury","volume":"38","author":"Tomassen","year":"2000","journal-title":"Spinal Cord"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Karcz, K., Schiffmann, B., Schwegler, U., Staubli, S., and Finger, M.E. (2022). Facilitators and Barriers to Sustainable Employment After Spinal Cord Injury or Acquired Brain Injury: The Person\u2019s Perspective. Front. Rehabil. Sci., 3.","DOI":"10.3389\/fresc.2022.872782"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2157","DOI":"10.1016\/j.apmr.2020.05.027","article-title":"Employment Among People with Spinal Cord Injury in 22 Countries Across the World: Results From the International Spinal Cord Injury Community Survey","volume":"101","author":"Post","year":"2020","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_15","unstructured":"din Rom\u00e2nia, S.A. (2009). Diagnostic: Exclus de pe pia\u021ba muncii. Piedici \u00een Ocuparea Persoanelor cu Dizabilit\u0103\u021bi \u00een Rom\u00e2nia, Alpha Media Print."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1097\/PHM.0000000000000678","article-title":"The International Spinal Cord Injury Survey and the Learning Health System for Spinal Cord Injury","volume":"96","author":"Stucki","year":"2017","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1097\/PHM.0000000000000647","article-title":"Study Protocol of the International Spinal Cord Injury (InSCI) Community Survey","volume":"96","author":"Post","year":"2017","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1097\/PHM.0000000000000622","article-title":"A Structured Approach to Capture the Lived Experience of Spinal Cord Injury: Data Model and Questionnaire of the International Spinal Cord Injury Community Survey","volume":"96","author":"Fekete","year":"2017","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_19","unstructured":"European Commission, Directorate General for Employment, Social Affairs and Inclusion, and Human European Consultancy (2021). European Semester 2020\u20132021 Country Fiche on Disability Equality: Romania, European Commission."},{"key":"ref_20","unstructured":"(2025, January 09). Persons with a Disability: Labor Force Characteristics, Available online: https:\/\/www.bls.gov\/news.release\/pdf\/disabl.pdf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"29","DOI":"10.16993\/sjdr.896","article-title":"Inclusion Opportunities of Work 4.0? Employment Realities of People with Disabilities in Germany","volume":"25","author":"Jochmaring","year":"2023","journal-title":"Scand. J. Disabil. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1080\/10790268.2009.11754553","article-title":"Review of Critical Factors Related to Employment After Spinal Cord Injury: Implications for Research and Vocational Services","volume":"32","author":"Ottomanelli","year":"2009","journal-title":"J. Spinal Cord Med."},{"key":"ref_23","first-page":"76","article-title":"A Narrative Review of Vocational Rehabilitation in People with Spinal Cord Injury in Different Countries","volume":"38","author":"Fatehi","year":"2024","journal-title":"Med. J. Islam. Repub. Iran"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"102020","DOI":"10.1016\/j.arr.2023.102020","article-title":"Aging with Spinal Cord Injury: A Narrative Review of Consequences and Challenges","volume":"90","author":"Grijalva","year":"2023","journal-title":"Ageing Res. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1038\/s41393-023-00953-8","article-title":"Relationship between Employment and Quality of Life and Self-Perceived Health in People with Spinal Cord Injury: An International Comparative Study Based on the InSCI Community Survey","volume":"62","author":"Escorpizo","year":"2024","journal-title":"Spinal Cord"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1310\/sci16-00055","article-title":"Relationships Between Community Reintegration and Clinical and Psychosocial Attributes in Individuals With Spinal Cord Injury in a Nigerian City","volume":"24","author":"Atobatele","year":"2018","journal-title":"Top. Spinal Cord Inj. Rehabil."},{"key":"ref_27","unstructured":"(2025, January 09). Convention on the Rights of Persons with Disabilities\u2014Articles | United Nations Enable. Available online: https:\/\/www.un.org\/development\/desa\/disabilities\/convention-on-the-rights-%20of-persons-with-disabilities\/convention-on-the-rights-of-persons-with-disabilities-2.html."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Butenschoen, V.M., Glo\u00dfner, T., Hostettler, I.C., Meyer, B., and Wostrack, M. (2022). Quality of Life and Return to Work and Sports after Spinal Ependymoma Resection. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-09036-9"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1080\/165019701750098902","article-title":"Factors Associated with Successful Vocational Rehabilitation in a Swedish Rural Area","volume":"33","author":"Marnetoft","year":"2001","journal-title":"J. Rehabil. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1080\/15017410309512612","article-title":"Vocational Rehabilitation between Work and Welfare\u2014The Swedish Experience","volume":"5","author":"Lindqvist","year":"2003","journal-title":"Scand. J. Disabil. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"S118","DOI":"10.1080\/10790268.2021.1955205","article-title":"Development of Employment Indicators to Advance the Quality of Spinal Cord Injury Rehabilitation Care: SCI-High Project","volume":"44","author":"Alavinia","year":"2021","journal-title":"J. Spinal Cord Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1186\/s12960-021-00606-y","article-title":"Diversifying the Health Workforce: A Mixed Methods Analysis of an Employment Integration Strategy","volume":"19","author":"Baumann","year":"2021","journal-title":"Hum. Resour. Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1310\/sci2601-21","article-title":"International Comparison of Vocational Rehabilitation for Persons With Spinal Cord Injury: Systems, Practices, and Barriers","volume":"26","author":"Roels","year":"2020","journal-title":"Top. Spinal Cord Inj. Rehabil."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"4381","DOI":"10.1080\/09638288.2022.2151651","article-title":"Factors Influencing Employment among People with Spinal Cord Injury in South Africa","volume":"45","author":"Bezuidenhout","year":"2023","journal-title":"Disabil. Rehabil."},{"key":"ref_35","unstructured":"(2025, January 10). LEGE Nr.95 Din 14 Aprilie 2006 Privind Reforma \u00een Domeniul S\u0103n\u0103t\u0103\u0163ii. Available online: https:\/\/www.cdep.ro\/pls\/legis\/legis_pck.htp_act_text?idt=72105."},{"key":"ref_36","unstructured":"(2025, January 09). ILOSTAT. Available online: https:\/\/ilostat.ilo.org\/glossary\/employment\/."}],"container-title":["NeuroSci"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2673-4087\/6\/1\/10\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:25:26Z","timestamp":1760027126000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2673-4087\/6\/1\/10"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,1]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["neurosci6010010"],"URL":"https:\/\/doi.org\/10.3390\/neurosci6010010","relation":{},"ISSN":["2673-4087"],"issn-type":[{"value":"2673-4087","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,1]]}}}