Study design: Prospective cohort study. Objective: To assess functional hindrance due to spasticity during inpatient rehabilitation and 1 year thereafter in individuals with spinal cord injury (SCI) and to determine factors that influence the hindrance. Setting: Eight specialized rehabilitation centres in the Netherlands. Methods: A total of 203 patients with recent SCI rated the hindrance they perceived due to spasticity in daily living at the start of active rehabilitation (t1), 3 months later (t2), at discharge (t3) and 1 year after discharge (t4). Hindrance was dichotomized into absent or negligible and present. Multilevel regression analyses were performed to determine the course of functional hindrance due to spasticity and its associations with possible determinants-namely, age, gender, cause, lesion level, motor completeness, spasticity and anti-spasticity medication. Results: The percentage of individuals that indicated functional hindrance due to spasticity ranged from 54 to 62% over time and did not change significantly over time (Δt3t1 odds ratio (OR) = 0.85, P = 0.44; Δt3t2 OR = 1.20, P = 0.41; Δt3t4 OR = 0.91, P = 0.67). The percentage of individuals who experienced a lot of hindrance due to spasticity during specific activities ranged from 4 to 27%. The odds for experiencing functional hindrance due to spasticity were significantly higher for individuals with tetraplegia (OR = 2.17, P = 0.0001), more severe spasticity (OR = 5.51, Po0.0001) and for those using anti-spasticity medication (OR = 4.18, Po0.0001). INTRODUCTIONSpasticity is defined as 'disordered sensori-motor control, resulting from an upper motor neuron lesion, presenting as intermittent or sustained involuntary activation of muscles'. 1 The literature has shown that 65-78% of individuals with chronic spinal cord injury (SCI) have symptoms of spasticity. 2,3 It has the potential to negatively influence the quality of life through restricting activities of daily living, causing pain and contributing to the development of contractures. 4,5 In a sample of SCI survivors, the prevalence of problematic spasticity at 1, 3 and 5 years following SCI was 35%, 31% and 27%, respectively. 5 These findings agree with the observations of Levi et al. 6 and Sköld et al. 3 Adriaansen et al. 7 reported problematic spasticity in 28-34% of individuals with SCI 1-5 years after discharge from inpatient rehabilitation. However, these studies do not describe how hindrance due to spasticity develops in the early phase after SCI. More knowledge is necessary about the course of hindrance over time and which activities of daily living are most hindered by spasticity in order to improve the management of spasticity.The aim of the present study was to describe functional hindrance due to spasticity during inpatient rehabilitation and 1 year thereafter