Understanding the role of environment in the creation of diseases and traumas and their organic, functional, and social consequences is at the heart of theoretical and practical debates in rehabilitation and disability studies. Starting with an analysis of recent conceptual evolution, we exemplify the environmental and systemic approach in individuals with spinal cord injury in three heuristic ways: (a) quality of participation as an outcome of interaction between personal factors and environment, (b) occurrence of secondary impairments and disabilities as an outcome of interaction between environment and participation profile, and (c) environmental adaptation as an outcome of organic, functional profile and participation profile.

disability process, environmental factors, interaction, outcomes, participation, rehabilitation, SCI, secondary disabilities, secondary impairments
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