Review article
Medical Rehabilitation in Natural Disasters: A Review

https://doi.org/10.1016/j.apmr.2015.02.007Get 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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  • Cited by (0)

    Supported by internal resources of the Rehabilitation Department, Royal Melbourne Hospital, Royal Park Campus, Melbourne, Australia.

    Disclosures: none.

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