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OBJECTIVE To identify the impact of moderate-to-severe spasticity on functioning in people living with spinal cord injury. DESIGN Secondary analysis of cross-sectional survey data using graphical modelling. SUBJECTS Individuals (n = 1,436) with spinal cord injury aged over 16 years with reported spasticity problems. METHODS Spasticity and 13 other impairments in body functions were assessed using the spinal cord injury Secondary Conditions Scale. Impairments in mental functions were assessed using the Mental Health subscale of the 36-it