Rehabilitation definition for research purposes: a global stakeholders' initiative by Cochrane Rehabilitation

Stefano Negrini, Melissa Selb, Carlotte Kiekens, Alex Todhunter-Brown, Chiara Arienti, Gerold Stucki, Thorsten Meyer

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Abstract

Objective Since its foundation, Cochrane Rehabilitation has faced challenges with rehabilitation definitions because existing definitions did not indicate what rehabilitation includes and what it excludes. We aimed to develop a comprehensive and shared rehabilitation definition for research purposes to: (1) support the conduct of primary studies and systematic reviews and (2) identify relevant systematic reviews for knowledge translation purposes. Design We performed a multimodal study including seven preliminary research and discussion papers, four Consensus Meetings, and three Delphi rounds with 80 rehabilitation stakeholders. The Delphi Study aimed to obtain agreement and refine and complete the items composing the definition and meanings of rehabilitation. These stakeholders covered 5 continents, representing 11 global and continental rehabilitation organizations, 11 scientific journals, 4 Cochrane Networks, and 3 Cochrane Groups and included invited experts and representatives of low middle-income countries and consumers. Results We had a 70% to 82.5% response rate to the three Delphi rounds, during which participants responded to all items (100%) and provided relevant comments (range, 5.5%-50% per item). This participation led to several refinements to the rehabilitation definition through three preliminary versions, and the final items reached an agreement between 88.9% and 100%. We structured the definition using the PICO (Population, Intervention, Comparison, Outcome) framework. We concluded that "In a healthcare context,"rehabilitation is defined as a "multimodal, person-centered, collaborative process"(Intervention-general), including interventions targeting a person's "capacity (by addressing body structures, functions, and activities/participation) and/or contextual factors related to performance"(Intervention-specific) with the goal of "optimizing"the "functioning"(Outcome) of "persons with health conditions currently experiencing disability or likely to experience disability, or persons with disability"(Population). Rehabilitation requires that all the items of the definition are satisfied. We defined a "rehabilitation intervention"as "any intervention provided within the rehabilitation process."Conclusions We developed a rehabilitation definition for research purposes achieving a broad agreement with global stakeholders. This definition provides explicit criteria to define rehabilitation. Using the proposed definition will improve rehabilitation research by standardizing the description of interventions. Our definition may require revision in the future, as further research enhances understanding and communication of the essence and complexity of rehabilitation.

Original languageEnglish
Pages (from-to)e100-e107
Number of pages8
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume101
Issue number7
DOIs
Publication statusPublished - Jul 2022

Keywords

  • rehabilitation, evidence-based medicine, clinical trial, health care
  • health care
  • clinical trial
  • rehabilitation
  • evidence-based medicine
  • Delphi technique
  • rehabilitation research
  • humans
  • research report
  • consensus
  • communication

ASJC Scopus subject areas

  • Medicine(all)

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