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Wade DT. Moving on. A farewell from the last Editor-in-Chief who says: 'Rehabilitation is a way of thinking, not a way of doing'. Clin Rehabil 2023; 37:287-293. [PMID: 36203369 DOI: 10.1177/02692155221131248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
What is rehabilitation? From 1994 to 2021, while I was privileged to be Editor of Clinical Rehabilitation, I explored this in editorials. I also encouraged and selected submissions that considered, in one way or another, the central features of rehabilitation. Why? Because when I started in rehabilitation, the general attitude among doctors and other healthcare professionals was that rehabilitation was pleasant but with no evidence of effectiveness. Further, they did not think a doctor had a role to play and did not think there was anything special for rehabilitation experts to know or have skills in. In this editorial, I discuss how, as editor, I used my position to support and encourage the publication of articles that produced evidence, considered the conceptual and scientific basis of rehabilitation, and ultimately answered the above question. I illustrate this with a few specific papers published in Clinical Rehabilitation. After 30 years, I have concluded that the essential feature characterising rehabilitation is its way of thinking about the patient's problems and how to solve them. Rehabilitation is holistic, person-centred, and concerned about social integration rather than disease or disability. Moreover, there is a mass of evidence showing it benefits patients.
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Affiliation(s)
- Derick T Wade
- Centre for Movement, Occupation and Rehabilitation Sciences (MOReS), 6395Oxford Brookes University, Oxford, UK
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Aadal L, Nielsen TL, Jensen AB, Bjerrum M, Nielsen CV, Angel S. What Does It Take for Research to Be Rehabilitation Research? FRONTIERS IN REHABILITATION SCIENCES 2022; 3:823159. [PMID: 36189071 PMCID: PMC9397732 DOI: 10.3389/fresc.2022.823159] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/17/2022] [Indexed: 11/13/2022]
Abstract
Six recommendations to facilitate rehabilitation research and supplement existing research practices were identified. Rehabilitation practice requires research addressing different long-term multi-faceted needs and perspectives of end users, including service users, professionals, politicians, and administrators. Research in rehabilitation should therefore integrate different research traditions and methods. Rehabilitation research with a broad focus is sparse, and most of the research takes its starting point in the biomedical research tradition. Through a nominal group process, we developed recommendations to emphasize important issues in rehabilitation research.
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Affiliation(s)
- Lena Aadal
- Hammel Neurorehabilitation and Research Center, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Tove Lise Nielsen
- Department of Occupational Therapy, Research Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark
| | | | - Merete Bjerrum
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, The Centre of Clinical Guidelines–Danish National Clearing House, Aalborg University, Aalborg, Denmark
| | - Claus Vinther Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus University, Aarhus, Denmark
- Department of Clinical Social Medicine and Rehabilitation, Gødstrup Hospital, Central Denmark Region, Aarhus University, Aarhus, Denmark
| | - Sanne Angel
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Molde University College, Molde, Norway
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Negrini S, Selb M, Kiekens C, Todhunter-Brown A, Arienti C, Stucki G, Meyer T. Rehabilitation Definition for Research Purposes: A Global Stakeholders' Initiative by Cochrane Rehabilitation. Am J Phys Med Rehabil 2022; 101:e100-e107. [PMID: 35583514 PMCID: PMC9197136 DOI: 10.1097/phm.0000000000002031] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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.
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Negrini S, Selb M, Kiekens C, Todhunter-Brown A, Arienti C, Stucki G, Meyer T. Rehabilitation definition for research purposes. A global stakeholders' initiative by Cochrane Rehabilitation. Eur J Phys Rehabil Med 2022; 58:333-341. [PMID: 35306803 PMCID: PMC9980575 DOI: 10.23736/s1973-9087.22.07509-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
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. 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, 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 (LMICs) and consumers. 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 health care 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." 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.
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Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale, " Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Melissa Selb
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland
| | | | - Alex Todhunter-Brown
- Nursing Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | | | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Luzern, Switzerland
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Negrini S, Selb M, Kiekens C, Todhunter-Brown A, Arienti C, Stucki G, Meyer T. Rehabilitation Definition for Research Purposes. A Global Stakeholders' Initiative by Cochrane Rehabilitation. Neurorehabil Neural Repair 2022; 36:405-414. [PMID: 35574944 DOI: 10.1177/15459683221093587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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. 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, 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. 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 health care 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." 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.
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Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Melissa Selb
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland
| | | | - Alex Todhunter-Brown
- Nursing Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, UK
| | | | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Luzern, Switzerland
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- Members are listed at the end of the paper
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