Trajectories of Rehabilitation across Complex Environment (TRaCE) 3.0

About the Project

A man sitting in a wheelchair with a dog on his lap in a white room, behind a desk. Behind the man sits a yellow couch, shelving and paintings on the brick wall

About

The transition from being an inpatient in hospital to living in the community with a spinal cord injury (SCI) or acquired brain injury (ABI) is challenging and requires many skills and resources for success. The TRaCE 3.0 project tracks the patterns of recovery over time for individuals with SCI and ABI, extending from inpatient rehabilitation discharge up to 24 months post-discharge. The study uses data collected from medical records, surveys and interviews to identify the timing of secondary complications, obstacles to service access, access to appropriate housing, and life stressors to determine how these affect independence, vocational outcomes and quality of life. TRaCE 3.0 builds on the previous TRaCE 1.0 (Trajectories of Rehabilitation across Complex Environments) and TRaCE 2.0 (Improving System Transitions and Access for Complex Rehabilitation Populations) projects by conducting a more in-depth exploration of service access and experiences of rehabilitation and support through semi-structured interviews.

Aim and objective

TRaCE 3.0 aims to:

1. Map and describe secondary complications, service access obstacles, and life stressors during the pathways back to home and work, as well as the stability of outcomes and wellbeing in people with SCI and ABI following discharge from inpatient rehabilitation.

2. Analyse personal expectations and experiences of rehabilitation and support after ABI and SCI following discharge and across the care continuum

3. Inform improved service coordination and individualised planning of appropriate, targeted and timely rehabilitation to improve outcomes

Expected outcomes and impact

Information gained from participants will provide an increased understanding of unmet need regarding specialist and generalist community services after discharge from inpatient rehabilitation, wellbeing, cost burden, secondary complications and stressors, and community reintegration outcomes.

Findings will generate in-depth understanding of people’s recovery trajectories and their experiences of rehabilitation, particularly in relation to the timing, nature and impact of secondary complications and life stressors and potential targets of intervention. This in turn will inform novel interventions and service models to improve timely access to rehabilitation that is matched to individuals’ personal preferences and life situations.

This research will highlight subgroups who are most at risk of poor outcomes and inform strategies for enhanced personalised rehabilitation pathways, through coordinated and targeted services and supports. TRaCE 3.0 will identify points in the journey following discharge where service access could be improved to facilitate return to independence and productive participation in work, the community, and social engagements.

Research Findings and Progress

Recruitment of participants to the study commenced in June 2023 and will continue until July 2024 (complete)
Discharge and 3 month post-discharge data collection is in progress and 12 month post-discharge data collection will commence in June 2024 (ongoing)
Project publication: Bray, E., Brough, R., Jones, R., Burridge, L., Geraghty, T., Mitchell, J., … Ownsworth, T. (2025). Setting me up or holding me back? Perspectives of people with spinal cord injury on rehabilitation supports at inpatient discharge and 3-months post-discharge. Disability and Rehabilitation, 1–13. https://doi.org/10.1080/09638288.2025.2476037 (Aug 2024)
Initial qualitative data analysis of discharge and 3 month post-discharge interview data has begun. Data collection will be completed late 2025 (ongoing)
Ongoing data collection and analysis at different time points (2024 - 2025 - ongoing)
Project publication: Laurie, K., Gustafsson, L., Foster, M. M., & Borg, D. N. (2025). Service access networks at 3- and 6-months after discharge from brain injury rehabilitation: an ego-network analysis. Disability and Rehabilitation, 1–11. https://doi.org/10.1080/09638288.2025.2513047. (June 2025)
Two psychology honours projects commenced on sentinel events during the first 12-months post-discharge after ABI and SCI (March 2025 - October 2025)
Conducted in-service meetings at PAH rehabilitation departments to share latest findings on the importance of post-discharge ABI rehabilitation and support matching individual needs and priorities (“Collaborative fit”) and facilitating re-engagement in activities and roles important to individuals’ sense of self (“Supporting self-continuity”) (April 2025)
Abstracts accepted for international conferences on rehabilitation (NR-SIG, July 2025) and SCI (ISCoS/NoSCoS, October 2025)

Initial analysis of the qualitative data from discharge and 3-month post-discharge interviews with participants with SCI identified three main themes, which depicted how services and supports influenced the process of resuming life. These included:

What matters to me – how services and supports helped with resuming life in personally meaningful ways.
Setting me up – the role of supports in enabling progress and positive transition
Holding me back – when services and supports were perceived as insufficient or unhelpful.

Initial analysis of the qualitative data from discharge and 3-month post-discharge interviews with participants with ABI and their family members has also commenced.

Project team

Chief Investigator: Prof. Timothy Geraghty (MSH/THC)

Research Team: