At Toronto Rehab, people with spinal cord injuries receive intensive rehabilitation to prepare them for their return to the community. But what happens after they are discharged? Dr. Kathryn Boschen, Research Scientist at Toronto Rehab, is working to answer this vital question.

"I do psychosocial research with people who've had a spinal cord injury, months or years after they've been here," says Dr. Boschen. "I try to link how they are doing in the community to what Toronto Rehab is doing in its programs. We need to learn how we can best help these people become functioning members of society again."

To see how well people reintegrate into the community after discharge, Dr. Boschen developed the MCI (Measure of Community Integration). This research tool looks at rehab-related factors affecting a person's integration and overall quality of life. But Dr. Boschen also knew that it's a two-way street. The receiving environment as well has a large impact on how well the person is able to reintegrate. So with colleagues from Quebec, she helped develop the Measure of the Quality of the Environment, to assess aspects of the person's surroundings that help or hinder the integration process.

One of the key areas her results point to is family and social support. "Our research suggests we need to learn more about how Toronto Rehab can also help those living long-term with someone with a spinal cord injury."

"Most support providers don't realize they sometimes need support themselves. There is burden, there is stress, there are issues - but we're finding support providers do adapt in the long term."

While support providers are an important resource for people with spinal cord injury (SCI), ultimately the clients themselves must meet the enormous challenge of readjusting to life in the community. Preparing them for this challenge is an important part of the Toronto Rehab mandate.

"People with SCI need help to adapt to their new circumstances. We want to be sure they maintain their independence and their dignity when they leave Toronto Rehab. We need to prepare them so they can go into a restaurant or take an elevator, or interact socially without embarrassment or discomfort."

Dr. Boschen sums it up based on the results of her research studies. "Ultimately, most of our SCI clients, newly in wheelchairs, do successfully make the move back into the community. We just need to remember to always look beyond the walls of our own facility. As rehab professionals, we need to do our best to make sure our clients, and their family members, are as ready as possible for the realities of life after rehab."