The effects of government disability benefits, accessibility laws and rehabilitation on employment choices by individuals with spinal cord injuries

Greater inclusion of individuals with disabilities into mainstream society is an important goal for society. One of the best ways to include individuals is to actively promote and encourage their participation in the labor force. Of all disabilities, it is feasible to assume that individual with spinal cord injuries can be among the most easily mainstreamed into the labor force. However, less that fifty percent of individuals with spinal cord injuries work. ^ This study focuses on how disability benefit programs, such as Social Security Disability Insurance, and Worker's Compensation, the Americans with Disabilities Act and rehabilitation programs affect employment decisions. The questions were modeled using utility theory with an augmented expenditure function and indifference theory. Statically, Probit, Logit, predicted probability, and linear regressions were used to analyze these questions. Statistical analysis was done on the probability of working, ever attempting to work after injury, and on the number of years after injury that work was first attempted and the number of hours worked per week. The data utilized were from the National Spinal Cord Injury Database and the Spinal Cord Injuries and Labor Database. The Spinal Cord Injuries and Labor Database was created specifically for this study by the author. Receiving disability benefits decreased the probability of working, of ever attempting to work, increased the number of years after injury before the first work attempt was made, and decreased the number of hours worked per week for those individuals working. These results were all statistically significant. The Americans with Disabilities Act decrease the number of years before an individual made a work attempt. The decrease is statistically significant. The amount of rehabilitation had a significant positive effect for male individuals with low paraplegia, and significant negative effect for individuals with high tetraplegia. For women, there were significant negative effects for high tetraplegia and high paraplegia. ^ This study finds that the financial disincentives of receiving benefits are the major determinants of whether an individual with a spinal cord injury returns to the labor force. Policies are recommended that would decrease the disincentive. ^

Joint-specific changes in locomotor complexity in the absence of muscle atrophy following incomplete spinal cord injury

ackground Following incomplete spinal cord injury (iSCI), descending drive is impaired, possibly leading to a decrease in the complexity of gait. To test the hypothesis that iSCI impairs gait coordination and decreases locomotor complexity, we collected 3D joint angle kinematics and muscle parameters of rats with a sham or an incomplete spinal cord injury. Methods 12 adult, female, Long-Evans rats, 6 sham and 6 mild-moderate T8 iSCI, were tested 4 weeks following injury. The Basso Beattie Bresnahan locomotor score was used to verify injury severity. Animals had reflective markers placed on the bony prominences of their limb joints and were filmed in 3D while walking on a treadmill. Joint angles and segment motion were analyzed quantitatively, and complexity of joint angle trajectory and overall gait were calculated using permutation entropy and principal component analysis, respectively. Following treadmill testing, the animals were euthanized and hindlimb muscles removed. Excised muscles were tested for mass, density, fiber length, pennation angle, and relaxed sarcomere length. Results Muscle parameters were similar between groups with no evidence of muscle atrophy. The animals showed overextension of the ankle, which was compensated for by a decreased range of motion at the knee. Left-right coordination was altered, leading to left and right knee movements that are entirely out of phase, with one joint moving while the other is stationary. Movement patterns remained symmetric. Permutation entropy measures indicated changes in complexity on a joint specific basis, with the largest changes at the ankle. No significant difference was seen using principal component analysis. Rats were able to achieve stable weight bearing locomotion at reasonable speeds on the treadmill despite these deficiencies. Conclusions Decrease in supraspinal control following iSCI causes a loss of complexity of ankle kinematics. This loss can be entirely due to loss of supraspinal control in the absence of muscle atrophy and may be quantified using permutation entropy. Joint-specific differences in kinematic complexity may be attributed to different sources of motor control. This work indicates the importance of the ankle for rehabilitation interventions following spinal cord injury.

The effects of government disability benefits, accessibility laws and rehabilitation on employment choices by individuals with spinal cord injuries

Greater inclusion of individuals with disabilities into mainstream society is an important goal for society. One of the best ways to include individuals is to actively promote and encourage their participation in the labor force. Of all disabilities, it is feasible to assume that individual with spinal cord injuries can be among the most easily mainstreamed into the labor force. However, less that fifty percent of individuals with spinal cord injuries work. This study focuses on how disability benefit programs, such as Social Security Disability Insurance, and Worker's Compensation, the Americans with Disabilities Act and rehabilitation programs affect employment decisions. The questions were modeled using utility theory with an augmented expenditure function and indifference theory. Statically, Probit, Logit, predicted probability, and linear regressions were used to analyze these questions. Statistical analysis was done on the probability of working, ever attempting to work after injury, and on the number of years after injury that work was first attempted and the number of hours worked per week. The data utilized were from the National Spinal Cord Injury Database and the Spinal Cord Injuries and Labor Database. The Spinal Cord Injuries and Labor Database was created specifically for this study by the author. Receiving disability benefits decreased the probability of working, of ever attempting to work, increased the number of years after injury before the first work attempt was made, and decreased the number of hours worked per week for those individuals working. These results were all statistically significant. The Americans with Disabilities Act decrease the number of years before an individual made a work attempt. The decrease is statistically significant. The amount of rehabilitation had a significant positive effect for male individuals with low paraplegia, and significant negative effect for individuals with high tetraplegia. For women, there were significant negative effects for high tetraplegia and high paraplegia. This study finds that the financial disincentives of receiving benefits are the major determinants of whether an individual with a spinal cord injury returns to the labor force. Policies are recommended that would decrease the disincentive.