Related Experiment Video
Updated: Aug 16, 2025

Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton
Published on: June 16, 2016
Characteristics Associated With Perceived Underemployment Among Participants With Spinal Cord Injury
James S Krause1, Clara E Dismuke-Greer2, Karla Reed3
1College of Health Professions, Medical University of South Carolina, Charleston, SC.
Objective:
To identify job characteristics related to perceived underemployment among people with spinal cord injury (SCI), while controlling for demographic, injury, and educational factors.
Design:
Cross-sectional, logistic regression with predicted probabilities of underemployment.
Setting:
Medical University in the Southeastern United States.
Participants:
952 were adults with traumatic SCI, all of whom were a minimum of 1-year post-injury and employed at the time of the study. They averaged 46.7 years of age, the majority were male (70.5%), and over half (52%) were ambulatory (N=952).
Interventions:
Not applicable.
Main Outcome Measures:
Perceived underemployment was defined and measured by a dichotomous variable (yes/no).
Results:
Demographic, injury, and educational factors explained only 4.8% of the variance in underemployment, whereas the full model explained 21.8%. Underemployment was significantly lower for women (odds ratio [OR]=0.66, 95% confidence interval [CI; .44, .98]), those who were either married or in a nonmarried couple (OR=0.63, 95% CI [.42, .93]), those with health benefits (OR=0.58, 95% CI [.37, .91]) and higher for those with lower earnings and occupations in the category of sales, professional/managerial. Postsecondary educational milestones, having received a promotion or recognition, and working full time were not identified as significant predictors in the multivariate model, although each was significantly related to a lower likelihood of underemployment when using a restricted model that controls only for demographics, SCI, and educational status (rather than all variables simultaneously). Age, years since injury, and injury severity were not significant.
Conclusion:
Underemployment is a concern among people with SCI and is more prevalent in low-paying jobs, without benefits, and opportunities for recognition and promotion. Vocational counseling strategies need to promote quality employment, including jobs with recognition and benefits.

