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Understanding Clinical Significance in Rehabilitation: A Primer for Researchers and Clinicians

Armijo-Olivo S, de Castro-Carletti EM, Calixtre LB, de Oliveira-Souza AIS, Mohamad N, Fuentes J

Am J Phys Med Rehabil, 2022 Jan 01;101(1):64-77.
PMID: 34091470 DOI: 10.1097/PHM.0000000000001799

The objective of this review was to summarize the concept of clinical significance and associated methods focusing on the area of rehabilitation to provide a resource to rehabilitation researchers and clinicians. Studies were searched on electronic databases from inception until July 28, 2020, with no date or language limits. Manual searches as well as Scopus forward citation for relevant references were performed. Narrative synthesis of study results was performed. Definitions of the concepts related to clinical significance, ways of calculating, and interpreting each method were provided using rehabilitation examples. An explanation of methods to evaluate clinical significance (distribution, anchor, and opinion-based methods) and their advantages and disadvantages were also provided. Considering the limitations of statistical significance in assuring meaningfulness of results, clinical interpretation of research outcomes and the report of clinical significance in intervention trials should be a priority in rehabilitation research. When possible, the use of multiple methods (distribution, anchor, and opinion based) is recommended. Thus, clinical researchers are encouraged to present results in a manner that allow the rehabilitation professionals to easily interpret and implement those results in their clinical practice.

Matched MeSH terms: Physical and Rehabilitation Medicine*
Fulltext The applictions of International Classification of Functioning, Disability and Health (ICF) by World Health Organization (WHO) in rehabilitation medicine practice

Lydia, A.L., Nazirah, H.

JUMMEC, 2007;10(2):16-21.
MyJurnal

Rehabilitation Medicine is dedicated to optimise patients function and health in the most comprehensive manner. ICF, the latest International Classification by World Health Organization (WHO) is a conceptual framework for the assessment of functioning, disability and health. The purpose of this paper is to describe the applications of ICF in Rehabilitation Medicine practice in the Medical Rehabilitation Unit, University of Malaya Medical Centre (UMMC), Kuala Lumpur. Issues: ICF consists of body function, structure, activity, participation and environmental factor. ICF categories are exhaustive, but are not practical to be used entirely and not applicable in clinical practice on their own. How is ICF used from the clinical perspective? It has to be adapted to make it usable. In Rehabilitation Medicine settings, the following are ways ICF is applied in clinical practice: research in terms of validating the use of available ICF Core Sets and development of new ICF Core Set; clinical practice based on the ICF-based sheet; and educational tools. Conclusion: The practice of Rehabilitation Medicine is in line and compatible with the concept of ICF and can serve as a new important language that can improve the practice of Rehabilitation Medicine. It can be a universal language in functioning, disability and health and can improve understanding in addressing issues on disability within the medical community, improve multi professionals’ communication among patients, healthcare providers and stakeholders.

Matched MeSH terms: Physical and Rehabilitation Medicine
Rehabilitation in Malaysia

Naicker AS, Mohamad Yatim S, Engkasan JP, Mazlan M, Yusof YM, Yuliawiratman BS, et al.

Phys Med Rehabil Clin N Am, 2019 11;30(4):807-816.
PMID: 31563172 DOI: 10.1016/j.pmr.2019.07.006

This article reviews the epidemiology, rehabilitation intervention strategies, and rehabilitation resources for persons with disabilities (PWD) in Malaysia. Currently, the registered number of PWD is 409,269 individuals, 1.3% of the total population, which is far less than the World Health Organization estimation of 10%. The rehabilitation implementation strategies include health policies, health promotion, and prevention programs. Health-related services for PWD are provided by many government agencies, including health, welfare, education, manpower, housing, and the private sector and nongovernment organizations. It is hoped national health programs can ensure special care and rehabilitation for PWD, optimizing self-reliance and social integration.

Matched MeSH terms: Physical and Rehabilitation Medicine/trends*
Perception of patients towards cardiac rehabilitation programme in Hospital Serdang

Bahanordin, J., Md Anuar, Abd.S., Roslan Johari, M.G., Teng, S.C., Mohd Azahadi, O., Siti Zubaidah, A.

Journal of Health Management, 2012;10(1):30-36.
MyJurnal

Purpose – Evidences have shown that participation in a cardiac rehabilitation programme improves outcomes and quality of life for cardiac patients. Hospital Serdang has conducted this programme since 2007 and it is the first to be run by the Rehabilitation Medicine Department. The purpose of this survey is to find out whether the programme is suitable, informative and useful from the patient’s perspective as well as to determine whether the 6 weeks duration is sufficient.

Design/ methodology/approach - A patient feedback survey using a self-administered questionnaire on the programme was conducted from January 2008 to December 2010 in Hospital Serdang.

Findings - A total of 323 patients were invited to join the programme but only 182 completed the programme and took part in this survey. 30% of the patients thought that the six weeks programme was not enough for them. 100% of the respondents agreed that the programme was beneficial, well suited to their problems and were willing to promote the programme to their friends. Therefore, it is recommended that this programme be extended to the community level.

Conclusion - In conclusion, this programme is beneficial, suitable, informative and adequate from the patient’s point of view. Extension of this programme into the community as a continuation of the hospital-based programme is likely to improve the outcome further.

Matched MeSH terms: Physical and Rehabilitation Medicine
Fulltext Implementation of Clinical Quality Management for Rehabilitation in Malaysia

Engkasan JP, Stucki G, Ali S, Yusof YM, Hussain H, Latif LA

J Rehabil Med, 2018 Apr 18;50(4):346-357.
PMID: 29159419 DOI: 10.2340/16501977-2283

In February 2017, the World Health Organization (WHO) launched its historic "Rehabilitation 2030: A Call for Action". Scaling up rehabilitation in health systems requires concerted action across all 6 components of WHO's Health Systems Framework. For rehabilitation, information about functioning is essential, as it is required for effective rehabilitation at all levels of the health system. What is missing is a countrywide demonstration project involving the implementation of a clinical quality management system for the continuous improvement of rehabilitation, both at the level of clinical care for individual patients and at the level of rehabilitation service provision. Consequently, the Department of Rehabilitation Medicine at the University of Malaya and University Malaya Medical Centre, together with the Cheras Rehabilitation Hospital of the Ministry of Health, and the Social Security Organisation (SOCSO) Rehabilitation Centre in Malacca, Malaysia, initiated a project to develop a Malaysian-wide clinical quality management system for rehabilitation (CQM-R Malaysia). The objective of this paper is to describe CQM-R Malaysia. First, a conceptual description of a CQM-R based on the International Classification of Functioning, Disability and Health (ICF) is set out. The methods, results and conclusions of a situation analysis conducted in January 2017 are then reported. Finally, the building blocks and implementation action plan developed for CQM-R Malaysia are presented.

Matched MeSH terms: Physical and Rehabilitation Medicine/methods*
Evidence-Synthesis Tools to Inform Evidence-Based Physiatry

Patrick Engkasan J, Rizzo JR, Levack W, Annaswamy TM

Am J Phys Med Rehabil, 2020 11;99(11):1072-1073.
PMID: 32576745 DOI: 10.1097/PHM.0000000000001508
Matched MeSH terms: Physical and Rehabilitation Medicine/methods*
Fulltext Evaluation of the topic lists used in two world Congresses (2015 and 2016) in Physical and Rehabilitation Medicine

Nugraha B, Paternostro-Sluga T, Schuhfried O, Stucki G, Franchignoni F, Abdul Latif L, et al.

J Rehabil Med, 2017 Jun 28;49(6):469-474.
PMID: 28537344 DOI: 10.2340/16501977-2232

BACKGROUND: Evaluation of the initial list of proposed abstract topics for Congresses of Physical and Rehabilitation Medicine (PRM) was needed in order to ensure its feasibility for use in future congress announcements and invitations for abstract submission.
METHODS: The initial proposals were based on 5 main areas of PRM research: biosciences in rehabilitation, biomedical rehabilitation sciences and engineering, clinical PRM sciences, integrative rehabilitation sciences, and human functioning sciences. This list became a model for structuring the abstracts for the 9th and 10th World Congresses of PRM, held in Berlin, Germany (2015) and Kuala Lumpur, Malaysia (2016), respectively. The next step was to evaluate the implementation of this model in both congresses.
RESULTS: It was found that the 5 main research areas were still used as the main principles (chapters) in which to organize the abstracts. However, some modifications have been made to cover topics that were not included in the initial proposal.
CONCLUSION: A more comprehensive list of topics has been developed, not only for topic list announcements, but also for the structuring and classification of abstracts for future international, regional or national PRM congresses.

Matched MeSH terms: Physical and Rehabilitation Medicine/organization & administration*
Cochrane Rehabilitation: Organization and Functioning

Negrini S, Arienti C, Gimigliano F, Grubišić F, Howe T, Ilieva E, et al.

Am J Phys Med Rehabil, 2018 01;97(1):68-71.
PMID: 28953033 DOI: 10.1097/PHM.0000000000000832
Matched MeSH terms: Physical and Rehabilitation Medicine/standards*
Fulltext Cochrane Rehabilitation: 2019 annual report

Arienti C, Kiekens C, Bettinsoli R, Engkasan JP, Gimigliano F, Grubisic F, et al.

Eur J Phys Rehabil Med, 2020 Feb;56(1):120-125.
PMID: 32093464 DOI: 10.23736/S1973-9087.20.06188-2

During its third year of existence, Cochrane Rehabilitation goals included to point out the main methodological issues in rehabilitation research, and to increase the Knowledge Translation activities. This has been performed through its committees and specific projects. In 2019, Cochrane Rehabilitation worked on five different special projects at different stages of development: 1) a collaboration with the World Health Organization to extract the best evidence for Rehabilitation (Be4rehab); 2) the development of a reporting checklist for Randomised Controlled Trials in rehabilitation (RCTRACK); 3) the definition of what is the rehabilitation for research purposes; 4) the ebook project; and 5) a prioritization exercise for Cochrane Reviews production. The Review Committee finalized the screening and "tagging" of all rehabilitation reviews in the Cochrane library; the Publication Committee increased the number of international journals with which publish Cochrane Corners; the Education Committee continued performing educational activities such as workshops in different meetings; the Methodology Committee performed the second Cochrane Rehabilitation Methodological Meeting and published many papers; the Communication Committee spread the rehabilitation evidence through different channels and translated the contents in different languages. The collaboration with several National and International Rehabilitation Scientific Societies, Universities, Hospitals, Research Centers and other organizations keeps on growing.

Matched MeSH terms: Physical and Rehabilitation Medicine*
Fulltext Advancing Academic Capacity in Physical and Rehabilitation Medicine to Strengthen Rehabilitation in Health Systems Worldwide: A Joint Effort by the European Academy of Rehabilitation Medicine, the Association of Academic Physiatrists, and the International Society of Physical and Rehabilitation Medicine

Frontera WR, Stucki G, Engkasan JP, Francisco GE, Gutenbrunner C, Hasnan N, et al.

Am J Phys Med Rehabil, 2022 Sep 01;101(9):897-904.
PMID: 35777886 DOI: 10.1097/PHM.0000000000002067
Matched MeSH terms: Physical and Rehabilitation Medicine*