Citation

Khan F, Amatya B, Gosney J, Rathore FA, Burkle FM. Arch. Phys. Med. Rehabil. 2015; 96(9): 1709-1727.

Affiliation

Harvard Humanitarian Initiative, Harvard School of Public Health, Cambridge, Massachusetts, USA.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.apmr.2015.02.007

PMID

25701639

Abstract

OBJECTIVES: To present an evidence-based overview of the effectiveness of medical rehabilitation intervention in natural disaster survivors and outcomes that are affected. DATA SOURCES: A literature search was conducted using medical and health science electronic databases (PubMed, Medline, EMBASE, CINAHL, Cochrane Library) up to September 2014. STUDY SELECTION: Two independent reviewers selected studies reporting outcomes for natural disaster survivors following medical rehabilitation that addressed functional restoration and participation. DATA EXTRACTION: Two reviewers independently extracted data and assessed the methodological quality of the studies using Critical Appraisal Skills Program's (CASP) appraisal tools. DATA SYNTHESIS: A meta-analysis was not possible due to heterogeneity amongst included trials, therefore a narrative analysis was performed for best evidence synthesis. Ten studies (2 randomised controlled trials, 8 observational studies) investigated a variety of medical rehabilitation interventions for natural disaster survivors to evaluate "best" evidence to date. The interventions ranged from comprehensive multidisciplinary rehabilitation to community educational programs. Studies scored low on quality assessment due to methodological limitations. The findings suggest 'some' evidence for the effectiveness of inpatient rehabilitation in reducing disability, improving participation and quality of life; and for community-based rehabilitation for participation. There was no data available for associated costs.

CONCLUSIONS: The findings highlight the need to incorporate medical rehabilitation into response planning and disaster management for future natural catastrophes. Access to rehabilitation and investment in sustainable infrastructure and education is crucial. More methodologically robust studies are needed to build evidence for rehabilitation programs, cost-effectiveness and outcome measurement in such settings.

Language: en