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Original research
Evaluating the feasibility of ReWork-SCI: a person-centred intervention for return-to-work after spinal cord injury
  1. Lisa Holmlund1,2,
  2. Susanne Guidetti1,
  3. Claes Hultling1,3,
  4. Åke Seiger1,2,
  5. Gunilla Eriksson1,4,
  6. Eric Asaba1,5
  1. 1Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
  2. 2Rehab Station Stockholm/Spinalis, R&D Unit, Rehab Station Stockholm, Stockholm, Sweden
  3. 3Department of Neurology, Karolinska Universitetssjukhuset, Solna, Sweden
  4. 4Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
  5. 5Research, Education, and Development Unit, Stockholms Sjukhem Foundation, Stockholm, Sweden
  1. Correspondence to Dr Lisa Holmlund; lisa.holmlund{at}


Objectives To evaluate the feasibility of: (1) ReWork-SCI with regard to adherence and acceptability and (2) a study design for evaluating ReWork-SCI with regard to recruitment, retention and outcome measures.

Design Pre-test and post-test, single group, feasibility study.

Setting Spinal cord injury (SCI) unit at a regional rehabilitation centre in Sweden.

Participants Two women and five men (n=7). Eligible criteria: (1) sustained traumatic or non-traumatic SCI; (2) completed the first acute care episode in a hospital; (3) between 18 to 65 years of age; (4) assessed by a physician as approachable for participation in the intervention; (5) history of permanent or temporary employment; (6) self-reported desire to return to work; and (7) ability to communicate in English or Swedish.

Intervention ReWork-SCI is a person-centred intervention for return-to-work (RTW), developed and evaluated using the Medical Research Council’s guidelines. ReWork-SCI follows a person-centred, structured and coordinated intervention process led by a coordinator within a SCI rehabilitation team.

Outcome measures The feasibility of ReWork-SCI and a study design was evaluated using a set of outcome measurement tools, vocational data, logbooks and semi-structured interviews.

Results All eligible participants accepted enrolment and follow-up. All participants had a plan for RTW after 3 months and four participants had initiated part-time work or work trial 6 months after commencement of intervention. Adherence and acceptability were overall good. Challenges of the intervention related to the person-centred follow-up, staff shortage and rootedness in the SCI team.

Conclusions ReWork-SCI was feasible and can contribute to a systematic design of an individualised plan, facilitate decision-making and build trust in the RTW process after SCI. Core features of the intervention was the systematic structure, use of a person-centred approach and dialogue with the employer. For the effectiveness of ReWork-SCI, modifications and considerations of study design are needed.

  • rehabilitation medicine
  • neurology
  • qualitative research

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors LH, EA and SG conceived the original idea, and all authors contributed to the outline and design of the study. LH has been responsible for developing the intervention in collaboration with all co-authors. LH, EA, CH and ÅS have been responsible for collaboration with the regional rehabilitation centre, while LH, GE and SG were responsible for training the coordinators. LH and EA were responsible for data collection. LH has been the main author and all co-authors discussed, contributed and commented on draft versions and approved the final version.

  • Funding This work was supported by the Doctoral School in Healthcare Sciences at Karolinska Institutet (Dnr 2-1955/2013), Norrbacka-Eugenia Foundation and Praktikertjänst Inc.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was obtained from the regional Ethical Review Board in Stockholm ( 2017/4:7).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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