Complex Rehabilitation in Systems under Immense Stress (CRISIS): Secondary complications and access to services during system disruption for people with Spinal Cord Injury (SCI)

About the Project


While Australia was effective in limiting the spread of COVID-19 at the start of the pandemic through government restrictions, social distancing, and international/state border closures, business as usual in the health system was significantly compromised. Non-essential services were reduced to increase hospital capacity and primary care was impacted. Ultimately, impacts on SCI and rehabilitation services were seen with the increased use of telehealth and reduced outpatient clinics and regional outreach visits.

During times of system stress (e.g., large-scale emergencies, natural disasters, and arguably pandemic conditions) and disruption to service access, people with disability, including those with SCI are at increased risk of neglect. Therefore it is important to examine how the pandemic impacted service access for people with SCI and their subsequent secondary complications, as well as identify potential solutions to implement in future times of system stress.

Aim and objective:

The main purpose of the CRISIS-SCI study is to explore how the COVID-19 pandemic impacted people with Spinal Cord Injury (SCI). This will be achieved by:

  1. Mapping the secondary complications, access concerns, and identifying problem-solving ideas during immense system stress, by analysing self-reported lived experience of people living with SCI in the community and the perspectives of critical stakeholders.
  2. Comparatively examining health and rehabilitation service use and secondary complications over an 18-month period in two SCI cohorts (discharge pre and post COVID). Additional analysis will take place to examine the differences in the outcomes for participants with motor vehicle accidence related SCI.  


This research will provide critical data on the impacts of health system stress for people with SCI, occurrence of secondary complications, and the potential risks to their wellbeing. The project will provide timely recommendations to improve system responsiveness by gathering evidence about the interconnections between secondary complications and access to services during the COVID-19 pandemic. It will provide detailed information to assist decision-making and planning regarding future preventative and management responses by clinicians, health administrators, funders and government. It will also uncover comprehensive information regarding motor vehicle accident related-SCI providing invaluable information for compulsory third-party insurers and life-time care funders.


The study will benefit all people with SCI by informing the development of evidence-based, disability-specific responses to such large-scale crises. It will also assist in identification of the most vulnerable sub-groups of people with SCI whose health care needs should be prioritised despite the immense system disruption.


The results for the 1st aim have been summarised in two summaries seen below and outlined in detail in the article: The Impacts and Vulnerabilities for People Living with Spinal Cord Injury and Their Service Systems of the COVID-19 Pandemic in Queensland, Australia.

Results summaries

Turquoise tile  Click here to view The CRISIS-SCI Study – Expert Stakeholder Forum Summary

Turquoise tile Click here to view The CRISIS-SCI Study – SCI Survey Summary


Title page infographic for the CRISIS-SCI study 

Infographic titled "Impacts of COVID-19 on People with SCI", with 4 sections: physical, psychological, access and solutions. Infographic titled "Expert Perspectives on the Impact of the COVID-19 Pandemic on SCI Services in QLD", with one large box in the middle describing the experts involved and 4 labels underneath: Service Disruption, Impact of Disruption, Change Drivers and Implications

Infographic with the number 1, titled "service disruption" with dot points  Infographic with the number 2, and title "impact of disruption" with dot points

Infographic tile with the number 3 and the title "change drivers" with dot points  Infographic with the number 4 and title "Implications" with dot points


Results for the second analyses are still underway.

People/organisations involved:

Prof Timothy Geraghty, Prof Michele Foster, Dr David Borg, Kiley Pershouse, Prof Tamara Ownsworth, A/Prof Melissa Kendall, Dr Sridhar Atresh, Greg Ungerer, Phillip Morris, Ross Duncan, Dr Letitia Burridge, Rachel Jones, Samantha Borg, Dr Christy Hogan, Dr Yanfei Xie, Jessica O’Loghlen.

This project was completed in partnership with The Hopkins Centre, Metro South Health, and Spinal Life Australia.

Project status and timeframe:

Surveys and expert stakeholder forums for Aim 1 were completed in 2021, with analyses and dissemination completed in 2022/early 2023. Results for the second analyses are still underway and due to be completed in 2023.

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