{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:25:17Z","timestamp":1754144717029,"version":"3.41.2"},"reference-count":33,"publisher":"Bristol University Press","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>Meaningful participation in occupations or employment and\/or the ability to engage in societal roles holds significant implications for one\u2019s wellbeing and is internationally recognised as a fundamental right for all persons, nowadays representing an emerging policy-making goal.<\/jats:p>\n<jats:p>We aimed to identify novel classes of individuals with chronic spinal cord injury (SCI) having similar long-term trajectories of community integration and relate them to their demographic and clinical features using a retrospective observational design.<\/jats:p>\n<jats:p>Community Integration Questionnaire (CIQ) follow-up assessments, motor Functional Independence Measure (mFIM) categorised as poor, fair or good, and Hospital Anxiety and Depression Scale (HADS) were analysed. Growth mixture models (GMM) were fitted to identify individuals with similar CIQ trajectories, classes\u2019 predictors were identified using multivariate logistic regression.<\/jats:p>\n<jats:p>GMM identified three classes of trajectories of community-dwelling adults with SCI (n=238) living in Catalonia, Spain assessed in-person (between 2002 and 2022) up to 19 years post-injury:\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Class 1 (n=46, 19.3 per cent): male (56.5 per cent), aged 53.5 (16.6) years at injury, mFIM (poor 39.1 per cent, fair 23.9 per cent, good 37.0 per cent), mean total CIQ=9.9 (3.4), depressive (21.7 per cent), tetraplegia (39.1 per cent).<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Class 2 (n=41, 17.3 per cent): male (56.1 per cent), 57.4 (14.8) years at injury, mFIM (poor 26.8 per cent, fair 12.2 per cent, good 61.0 per cent), CIQ=9.3 (3.8), depressive (7.3 per cent), paraplegia (65.9 per cent).<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Class 3 (n=151, 63.4 per cent): male (68.9 per cent), 43.6 (15.9) years at injury, mFIM (poor 11.9 per cent, fair 13.9 per cent, good 74.2 per cent), CIQ=17.7 (3.3), depressive (4.0 per cent), paraplegia (74.2 per cent).<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p>\n<jats:p>Admission age, higher education (university), mFIM and HADS depression predict good community integration, AUC: 0.82 (0.73\u20130.91). Our results suggest possible course of action focusing on specific aspects to promote community integration.<\/jats:p>","DOI":"10.1332\/17579597y2025d000000051","type":"journal-article","created":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T18:19:46Z","timestamp":1751134786000},"page":"335-354","source":"Crossref","is-referenced-by-count":0,"title":["Long-term trajectories of community integration after spinal cord injury in a Mediterranean setting: identification, characterisation and trajectory predictors"],"prefix":"10.1332","volume":"16","author":[{"given":"Alejandro","family":"Garc\u00eda-Rudolph","sequence":"first","affiliation":[{"name":"Institut Guttmann, Universitat Aut\u00f2noma de Barcelona, Bellaterra (Cerdanyola del Vall\u00e8s) and Fundaci\u00f3 Institut d\u2019Investigaci\u00f3 en Ci\u00e8ncies de la Salut Germans Trias i Pujol, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Wright","sequence":"additional","affiliation":[{"name":"Institut Guttmann, Universitat Aut\u00f2noma de Barcelona, Bellaterra (Cerdanyola del Vall\u00e8s) and Fundaci\u00f3 Institut d\u2019Investigaci\u00f3 en Ci\u00e8ncies de la Salut Germans Trias i Pujol, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loreto","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Institut Guttmann, Universitat Aut\u00f2noma de Barcelona, Bellaterra (Cerdanyola del Vall\u00e8s) and Fundaci\u00f3 Institut d\u2019Investigaci\u00f3 en Ci\u00e8ncies de la Salut Germans Trias i Pujol, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep Maria","family":"Tormos","sequence":"additional","affiliation":[{"name":"Institut Guttmann, Universitat Aut\u00f2noma de Barcelona, Bellaterra (Cerdanyola del Vall\u00e8s) and Fundaci\u00f3 Institut d\u2019Investigaci\u00f3 en Ci\u00e8ncies de la Salut Germans Trias i Pujol, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eloy","family":"Opisso","sequence":"additional","affiliation":[{"name":"Institut Guttmann, Universitat Aut\u00f2noma de Barcelona, Bellaterra (Cerdanyola del Vall\u00e8s) and Fundaci\u00f3 Institut d\u2019Investigaci\u00f3 en Ci\u00e8ncies de la Salut Germans Trias i Pujol, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"165","reference":[{"issue":"4","key":"CIT0001","series-title":"International Journal of Rehabilitation Research","first-page":"267","article-title":"Predictors of reintegration to normal living in older adults discharged from an intensive rehabilitation program","volume":"31","author":"Bourdeau, I.","year":"2008","unstructured":"Bourdeau, I., Desrosiers, J. and Gosselin, S. (2008) Predictors of reintegration to normal living in older adults discharged from an intensive rehabilitation program, International Journal of Rehabilitation Research, 31(4): 267\u201374, doi: 10.1097\/MRR.0b013e3282fc0ff2"},{"issue":"4","key":"CIT0002","series-title":"Clinical Rehabilitation","first-page":"352","article-title":"Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide","volume":"23","author":"Bovend\u2019Eerdt, T.J.","year":"2009","unstructured":"Bovend\u2019Eerdt, T.J., Botell, R.E. and Wade, D.T. 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(2007) The effect of the introduction of a case-mix-based funding model of rehabilitation for severe stroke: an Australian experience, Archives of Physical Medicine and Rehabilitation, 88: 827\u201332, doi: 10.1016\/j.apmr.2007.04.001"},{"issue":"2","key":"CIT0004","series-title":"NeuroRehabilitation","first-page":"91","article-title":"Community integration in spinal cord injury of long duration","volume":"19","author":"Charlifue, S.","year":"2004","unstructured":"Charlifue, S. and Gerhart, K. (2004) Community integration in spinal cord injury of long duration, NeuroRehabilitation, 19(2): 91\u2013101."},{"issue":"11","key":"CIT0005","series-title":"Archives of Physical Medicine and Rehabilitation","first-page":"2212","article-title":"Rehabilitation the health strategy of the 21st century, really?","volume":"100","author":"Cieza, A.","year":"2019","unstructured":"Cieza, A. (2019) Rehabilitation the health strategy of the 21st century, really?, Archives of Physical Medicine and Rehabilitation, 100(11): 2212\u201314, doi: 10.1016\/j.apmr.2019.05.019"},{"key":"CIT0006","series-title":"British Journa of Health Psychology","first-page":"807","article-title":"Adjustment following chronic spinal cord injury: determining factors that contribute to social participation","volume":"20","author":"Craig, A.","year":"2015","unstructured":"Craig, A., Nicholson Perry, K., Guest, R., Tran, Y. and Middleton, J. (2015) Adjustment following chronic spinal cord injury: determining factors that contribute to social participation, British Journa of Health Psychology, 20: 807\u201323, doi: 10.1111\/bjhp.12143"},{"issue":"4","key":"CIT0007","series-title":"Rheumatology (Oxford)","first-page":"1891","article-title":"Juvenile Dermatomyositis Research Group. 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