{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:31:54Z","timestamp":1779186714860,"version":"3.51.4"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spinal Cord"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Study design<\/jats:title>\n            <jats:p>Narrative review<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>Sir Ludwig Guttmann realised spinal cord injury (SCI) rehabilitation should incorporate more than a biomedical approach if SCI patients were to adjust to their injury and achieve productive social re-integration. He introduced components into rehabilitation he believed would assist his patients build physical strength as well as psychological resilience that would help them re-engage with their communities. We pay tribute to Sir Ludwig by presenting research that has focussed on psychosocial factors that contribute to adjustment dynamics after SCI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting<\/jats:title>\n            <jats:p>Not applicable.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Five factors with a psychosocial source will be examined, featured in my research, namely psychological distress, cognitive impairment, pain catastrophizing, sleep disorder and fatigue. A multifactorial model of adjustment will be examined.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Evidence shows these factors can be significant barriers to adjustment and reciprocally related to self-efficacy and life decisions. A theoretical rehabilitation framework\/model is presented called the SCI Adjustment Model (SCIAM), that explains the process of adjustment dynamics. It describes how multifactorial factors contribute to adjustment in a non-linear process over time.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Key clinical messages include: (i) adjustment dynamics will be enhanced if viewed through the lens of a multifactorial model that clarifies how multiple psychosocial factors can combine and act as barriers or facilitators to adjustment; (ii) judiciously using this information, assess and then strategize to reduce the influence of barriers or strengthen facilitators during SCI rehabilitation and beyond, and (iii) integrate psychosocial guidelines and a person-centred approach into SCI rehabilitation to achieve treatment goals.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s41393-025-01060-6","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T18:19:37Z","timestamp":1737137977000},"page":"194-200","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Sir Ludwig Guttmann lecture 2023: psychosocial factors and adjustment dynamics after spinal cord injury"],"prefix":"10.1038","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7647-7604","authenticated-orcid":false,"given":"Ashley","family":"Craig","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"1060_CR1","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1038\/sc.2012.109","volume":"50","author":"HL Frankel","year":"2012","unstructured":"Frankel HL. 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