"Rehabilitation Research Framework for Patients With COVID-19" Defined by Cochrane Rehabilitation and the World Health Organization Rehabilitation Programme

Abstract

The coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of research activity. Since its outset, efforts have been made to guide the rapid generation of research in medicine. There are gaps in some areas of rehabilitation research for patients with COVID-19. The development of a specific research framework might serve to help monitor the status of research (mapping), shape and strengthen research by pointing to under-investigated areas, and promote rehabilitation research in this context. This article introduces and discusses the COVID-19 Rehabilitation Research Framework (CRRF) and presents the methodology used for its development. The questions have been developed among the World Health Organization (WHO) Rehabilitation Programme, Cochrane Rehabilitation, and the experts of its Rehabilitation-COVID-19 Evidence-based Response Action International Multiprofessional Steering Committee. The framework is divided into 2 parts and includes 20 questions organized in 4 groups: epidemiology, and evidence at the micro- (individual), meso- (health services), and macro- (health systems) levels. The CRRF offers a comprehensive view of the research areas relevant to COVID-19 and rehabilitation that are necessary to inform best practice and ensure rehabilitation services and health systems can best serve the population with COVID-19. The collaboration between Cochrane Rehabilitation and the WHO Rehabilitation Programme in establishing the CRRF brought together perspectives from the health systems, health management, and clinical evidence. The authors encourage researchers to use the CRRF when planning studies on rehabilitation in the context of COVID-19.

Keywords: COVID-19; International Classification of Functioning, Disability and Health; Rehabilitation.

Fig 1

Growth of evidence on rehabilitation and COVID-19 based on the monthly living systematic review conducted by the Steering Committee,^,,, , , , , following the Oxford Centre for Evidence-Based Medicine level of evidence levels of evidence, where level 1 is the strongest and level 4 is the lowest.

Fig 2

This figure represents the evidence mapping on rehabilitation and COVID-19 based on the monthly living systematic review conducted by the Steering Committee.^,,, , , , , The map gathers in a single view the quantity of information in the literature and its distribution according to the CRRF. All details of the map can be seen on the Cochrane Rehabilitation website at the link https://rehabilitation.cochrane.org/covid-19/reh-cover-interactive-living-evidence. The columns include the LFRI divided in the different COVID-19 phases of care and populations according to Part I of the CRRF (see table 1), and the rows include the research questions of Part II of the CRRF (see table 2). In each resulting square, 4 circles represent the quality of evidence (1 per color: RCT, non-RCT, analytical, descriptive studies) and the number of studies (the bigger the circle, the more studies). Clicking on the circles, it is possible to “explode” the information and retrieve all single articles with related information.