title: Medical Rehabilitation in Natural Disasters: A Review.
abstract: OBJECTIVE
  To present an evidence-based overview of the effectiveness of medical rehabilitation intervention in natural disaster survivors and outcomes that are affected.
  
  
  METHODS
  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.
  
  
  METHODS
  Two independent reviewers selected studies reporting outcomes for natural disaster survivors after medical rehabilitation that addressed functional restoration and participation.
  
  
  METHODS
  Two reviewers independently extracted data and assessed the methodologic quality of the studies using the Critical Appraisal Skills Program's appraisal tools.
  
  
  RESULTS
  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.
authors.affiliation: Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia; Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Committee for Rehabilitation Disaster Relief, International Society of Physical and Rehabilitation Medicine, Geneva, Switzerland. Electronic address: fary.khan@mh.org.au.
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
authors.affiliation: Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.
authors.forename: Bhasker
authors.initials: B
authors.lastname: Amatya
authors.affiliation: Committee for Rehabilitation Disaster Relief, International Society of Physical and Rehabilitation Medicine, Geneva, Switzerland.
authors.forename: James
authors.initials: J
authors.lastname: Gosney
authors.affiliation: Committee for Rehabilitation Disaster Relief, International Society of Physical and Rehabilitation Medicine, Geneva, Switzerland; Department of Rehabilitation Medicine, Combined Military Hospital Lahore Medical College, University of Health Sciences, Lahore, Pakistan.
authors.forename: Farooq A
authors.initials: FA
authors.lastname: Rathore
authors.affiliation: Harvard Humanitarian Initiative, Harvard School of Public Health, Cambridge, MA.
authors.forename: Frederick M
authors.initials: FM
authors.lastname: Burkle
mesh_terms: D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D004190:Disasters; D006801:Humans; D026761:Physical Therapy Specialty / Q000458:organization & administration*; D011788:Quality of Life; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000523:psychology / Q000534:rehabilitation*
keywords: Community integration; Disaster survivors, earthquake; Physical functioning; Quality of life; Rehabilitation