Multidisciplinary rehabilitation in persons with multiple trauma: A systematic review
Reem Al Hanna, Bhasker Amatya, L. Eduardo Cofré Lizama, Mary P. Galea, Fary Khan
Department of Rehabilitation Medicine, Royal Melbourne Hospital, 3052 Melbourne, Australia. E-mail: Reem.AlHanna@mh.org.au
Objective: To determine the effectiveness of multidisciplinary rehabilitation in improving functional and psychological outcomes in person with multiple trauma.
Date sources: A comprehensive literature review was conducted using medical and health science electronic databases up to February 2019.
Data extraction: Two independent reviewers selected studies, extracted data and assessed study quality using the Critical Appraisal Skills Programme (CASP) checklists and Grading of Recommendations, Assessment, Development and Evaluations (GRADE).
Data synthesis: One randomized controlled trial, 1 clinical controlled trial and 4 observational studies (1 with 2 reports) were included. Qualitative analysis was used to synthesize the evidence due to the heterogeneity of included trials. The quality of the studies varied (CASP approach); the majority were of “low quality”. The findings suggest “very low to moderate” evidence (GRADE) for the effectiveness of multidisciplinary rehabilitation in improving functional ability and participation. The majority of studies (n = 6) reported functional improvements after multidisciplinary rehabilitation in the short-term.
Conclusion: The lack of “high-quality” evidence for multidisciplinary rehabilitation in improving outcomes following trauma highlights gaps in the available evidence, signifying the need for more robust studies.
Trauma is major cause of death and disability worldwide. An increasing number of people survive multiple traumatic injuries due to improvements in emergency, surgical and trauma services. Rehabilitation is therefore necessary to maximize patients’ function and successful societal reintegration. This study assessed the evidence from published clinical studies to determine the effectiveness of multidisciplinary rehabilitation in improving function in persons with multiple traumatic injuries. The findings suggest limited high-quality evidence to support multidisciplinary rehabilitation for improved function and quality of life. Further research with better study design is needed to justify multidisciplinary rehabilitation in the management of survivors of multiple trauma.
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