Functional independence following spinal cord injury

Search this resource

Some people with a spinal cord injury (SCI) will have the ability to achieve a high level of functional independence. Others may be limited by their physical ability but will be able to achieve a level of independence through directing their care and by using assistive technology options.

A person’s neurological level should not be viewed as strictly predictive but rather as indicative of potential function. There are many factors that have an impact on an individual’s functional performance.

Factors that affect functional performance

  • Neurological level (tetraplegia or paraplegia)
  • Degree of impairment (expressed as complete or incomplete, or using the American Spinal Injury Association International Standards for Neurological Classification of Spinal Cord Injury score)1
  • Age at time of injury and years since injury
  • Other injuries or medical conditions, for example fractures, nerve injuries, cardiac disease, arthritis
  • Physique (body proportion and weight distribution)
  • Cognition and motivation (impact of traumatic brain injury)
  • Mental illness, for example depression, schizophrenia, personality disorder
  • Drug and alcohol abuse
  • Social supports
  • Cultural expectations
  • Financial resources
  • Environmental factors.

Changes with ageing

A person’s functional status may change as they age with an SCI. Musculoskeletal changes associated with ageing have a greater impact on people with an SCI and their level of independence than on the able-bodied population. Musculoskeletal problems with overuse syndromes are common.

See Potential levels of functional independence and equipment needs for further information about the expected functional outcomes and equipment requirements for people with different levels of spinal cord injury.

  1. The American Spinal Injury Association. International Standards for Neurological Classification of SCI (ISNCSCI) Worksheet [Internet]. 2019 revision. Richmond, VA, USA: The American Spinal Injury Association; 2019 [cited 20 Oct 2021].
Back to top