Medical Rehabilitation in Natural Disasters: A Review

doi:10.1016/j.apmr.2015.02.007

Archives of Physical Medicine and Rehabilitation

Volume 96, Issue 9, September 2015, Pages 1709-1727

https://doi.org/10.1016/j.apmr.2015.02.007 Get rights and content

Abstract

Objective

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, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PsycINFO) up to September 2014.

Study Selection

Two independent reviewers selected studies reporting outcomes for natural disaster survivors after medical rehabilitation that addressed functional restoration and participation.

Data Extraction

Two reviewers independently extracted data and assessed the methodologic quality of the studies using the Critical Appraisal Skills Program's appraisal tools.

Data Synthesis

A meta-analysis was not possible because of heterogeneity among included trials; therefore, a narrative analysis was performed for best evidence synthesis. Ten studies (2 randomized 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 because of methodologic limitations. The findings suggest some evidence for the effectiveness of inpatient rehabilitation in reducing disability and improving participation and quality of life and for community-based rehabilitation for participation. There were 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 are crucial. More methodologically robust studies are needed to build evidence for rehabilitation programs, cost-effectiveness, and outcome measurement in such settings.

Section snippets

Methods

A comprehensive, integrated approach was used to review the literature (peer review, gray literature) for medical rehabilitation interventions in natural disasters. A search of the peer-review literature was conducted using medical and health science electronic databases (MEDLINE, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Library) from 2000 to September 2014. The terms natural disaster, disaster management, and rehabilitation interventions,

Results

The combined searches retrieved 2766 published titles and abstracts, of which 2751 were screened after removal of duplicates. Thirty-four abstracts met preliminary inclusion criteria, and full texts of these articles were assessed; 19 of these were excluded because of inappropriate study design (systematic reviews, narrative reviews, commentaries) or because they were not related to natural disasters. Four additional relevant articles were identified from bibliographies. Ten studies (2

Discussion

This systematic review provides an evidence-based overview of the effectiveness of various medical rehabilitation interventions used for survivors of natural disasters. A multipronged approach assimilated published literature for currently available evidence by including both qualitative and quantitative studies. The study highlights scarce research and a lack of robust, methodologically strong studies in this area. Most included studies were of poor quality as a result of multiple methodologic

Conclusions

This review highlights sparse literature and the lack of high-quality studies in rehabilitation after natural disasters. Assimilation of data from existing studies was difficult because of the diverse content, delivery of rehabilitation, and range of outcome measures used. Although evidence for effectiveness of rehabilitation in natural disaster victims is limited, the gap in current research should not be interpreted as ineffectiveness of rehabilitation in this population. The challenge is to

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Modern neurological rehabilitation medicine and its clinical research results show that through the scientific rehabilitation training, the damaged limb motor function can be restored to some extent. During the entire rehabilitation process, the physician needs to monitor and evaluate the patient’s physical condition and training effect in real time in order to develop or adjust the follow-up rehabilitation training program. Therefore, this paper takes the sports rehabilitation training as the background and based on the Internet of Things technology to develop a sports rehabilitation monitoring system based on wearable sensors and Internet of Things technology. Through the development of the sensory sensor monitoring sensor terminal node, based on the needs of physiological parameter monitoring during the rehabilitation training process, a monitoring system including electrocardiogram (ECG) signals, electromyography (EMG) signals, motion posture, body temperature and other physiological parameters was constructed based on the Internet of Things technology. The experimental results show that the system constructed in this paper can closely monitor the changes of vital signs of target users while providing real-time monitoring, and provide feedback. These physiological data can be analyzed to help doctors formulate effective rehabilitation training programs. Evaluate the recovery of exercise capacity and training participation, so as to achieve the purpose of improving training efficiency and achieving rehabilitation effects
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Further, the roles and responsibilities of the rehabilitation personnel can change as the disaster response progresses to reflect evolving clinical and rehabilitation needs.21 The rehabilitation continuum model (Fig. 3) suggests a plan of rehabilitation intervention after a natural disaster, which includes a response phase based on individual clinical needs for acute and core rehabilitation stages (including community-based rehabilitation).10,21 This model is based on assumptions of availability of rehabilitation services and workforce, and to our knowledge, is yet to be empirically tested.
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: Supported by internal resources of the Rehabilitation Department, Royal Melbourne Hospital, Royal Park Campus, Melbourne, Australia.

: Disclosures: none.

View full text

Review articleMedical Rehabilitation in Natural Disasters: A Review

Abstract

Objective

Data Sources

Study Selection

Data Extraction

Data Synthesis

Conclusions

Section snippets

Methods

Results

Discussion

Conclusions

Arch Phys Med Rehabil

ReliefWeb Project. Glossary of humanitarian terms

Annual disaster statistical review 2009: the numbers and trends

Developing post-disaster physical rehabilitation: role of the World Health Organization Liaison Sub-Committee on Rehabilitation Disaster Relief of the International Society of Physical and Rehabilitation Medicine

J Rehabil Med

Natural disasters and sustainable development: understanding the links between development, environment and natural disasters. Background Paper No. 5

Disability and health-related rehabilitation in international disaster relief

Glob Health Action

Three decades of disasters: a review of disaster-specific literature from 1977-2009

Prehosp Disaster Med

Global assessment report on disaster risk reduction (GAR)

Disaster rehabilitation: towards a new perspective

Humanitarian response following the earthquake in Haiti: reflections on unprecedented need for rehabilitation

World Health Popul

World report on disability

Systematic review of multidisciplinary rehabilitation in patients with multiple trauma

Br J Surg

International classification of functioning, disability and health (ICF)

Classification and minimum standards for foreign medical teams in sudden onset disasters

Meeting the challenges of spinal cord injury care following sudden onset disaster: lessons learned

J Rehabil Med

Medical rehabilitation of spinal cord injury following earthquakes in rehabilitation resource-scarce settings: implications for disaster research

Spinal Cord

Bias in location and selection of studies

BMJ

Review article
Medical Rehabilitation in Natural Disasters: A Review