Medical Rehabilitation in Natural Disasters: A Review

Arch Phys Med Rehabil. 2015 Sep;96(9):1709-27. doi: 10.1016/j.apmr.2015.02.007. Epub 2015 Feb 18.


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.

Keywords: Community integration; Disaster survivors, earthquake; Physical functioning; Quality of life; Rehabilitation.

Publication types

  • Review

MeSH terms

  • Disabled Persons / psychology
  • Disabled Persons / rehabilitation*
  • Disasters*
  • Humans
  • Physical Therapy Specialty / organization & administration*
  • Quality of Life
  • Trauma Severity Indices
  • Wounds and Injuries / psychology
  • Wounds and Injuries / rehabilitation*