Musculoskeletal trauma rehabilitation: a global comparison

Brian Bernstein¹, Douglas W Lundy², Theodore A Miclau³, Zsolt J Balogh⁴, Shimpei Kitada⁵, Ross Leighton⁶, Guy Putzeys⁷, Luis G Padilla Rojas⁸, Inger Schipper⁹, Linda Vallejo¹⁰, Jonathan Tamayo-Cosio¹¹, Dario E Garin Zertuche¹², Cristian A Rojas Herrera¹³, José Octavio Soarez Hungria¹⁴, Jaime A Leal Camacho¹⁵, Marcelo T Caiero¹⁶, Horacio Tabares Neyra¹⁷, Vincenzo Giordano¹⁸, Hans-Christoph Pape¹⁹, Theodore Miclau²⁰

Affiliations

¹ Department of Orthopaedic Surgery, University of Cape Town, Cape Orthopaedic Trauma Group, Cape Town, South Africa.
² Department of Orthopaedic Surgery, St. Luke's University Health Network, Bethlehem, PA.
³ Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, MN.
⁴ Department of Traumatology, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia.
⁵ Department of Orthopaedic Reconstruction Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan.
⁶ Department of Surgery, Dalhousie University, Halifax, NS, Canada.
⁷ Orthopaedic and Trauma Department, AZ Groeninge Hospital, Kortrijk, Belgium.
⁸ Metropolitana de Guadalajara University, Puerta de Hierro Hospital, Guadalajara, Jalisco, Mexico.
⁹ Department of Trauma Surgery, Leiden University Medical Center, Leiden, the Netherlands.
¹⁰ Department of Orthopaedic Surgery, Hospital Universitario Mayor MEDERI, Hospital Central de la Policía Nacional, Hospital Universitario Nacional, Bogotá, Colombia.
¹¹ CORE Rehabilitation and Physiotherapy Center, Madrid School of Osteopathy-Campus Mexico, Guadalajara, Mexico.
¹² Department of Orthopaedic Surgery, Autonoma de Baja California University, Angeles Hospital, Tijuana, Baja California, Mexico.
¹³ Orthopaedic Department, San Rafael Hospital, Tunja, Colombia.
¹⁴ Grupo de Trauma Ortopédico, Instituto de Ortopedia, Santa Casa de São Paulo, São Paulo, Brazil.
¹⁵ Department of Orthopaedic Surgery, Hospital Universitario de La Samaritana, Bogotá, Colombia.
¹⁶ Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
¹⁷ Department of Surgery, Center for Research in Longevity, Aging and Health, La Havana, Cuba.
¹⁸ Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Ortopedia, Clínica São Vicente, Rede D'Or São Luiz, Rio de Janeiro, Brazil.
¹⁹ Department of Trauma, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
²⁰ Department of Orthopaedic Surgery, University of California, Orthopaedic Trauma Institute, San Francisco School of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA.

PMID: 41098362
PMCID: PMC12519553
DOI: 10.1097/OI9.0000000000000437

Musculoskeletal trauma rehabilitation: a global comparison

Brian Bernstein et al. OTA Int. 2025.

. 2025 Oct 13;8(6 Suppl):e437.

doi: 10.1097/OI9.0000000000000437. eCollection 2025 Oct.

Authors

Affiliations

¹ Department of Orthopaedic Surgery, University of Cape Town, Cape Orthopaedic Trauma Group, Cape Town, South Africa.
² Department of Orthopaedic Surgery, St. Luke's University Health Network, Bethlehem, PA.
³ Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, MN.
⁴ Department of Traumatology, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia.
⁵ Department of Orthopaedic Reconstruction Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan.
⁶ Department of Surgery, Dalhousie University, Halifax, NS, Canada.
⁷ Orthopaedic and Trauma Department, AZ Groeninge Hospital, Kortrijk, Belgium.
⁸ Metropolitana de Guadalajara University, Puerta de Hierro Hospital, Guadalajara, Jalisco, Mexico.
⁹ Department of Trauma Surgery, Leiden University Medical Center, Leiden, the Netherlands.
¹⁰ Department of Orthopaedic Surgery, Hospital Universitario Mayor MEDERI, Hospital Central de la Policía Nacional, Hospital Universitario Nacional, Bogotá, Colombia.
¹¹ CORE Rehabilitation and Physiotherapy Center, Madrid School of Osteopathy-Campus Mexico, Guadalajara, Mexico.
¹² Department of Orthopaedic Surgery, Autonoma de Baja California University, Angeles Hospital, Tijuana, Baja California, Mexico.
¹³ Orthopaedic Department, San Rafael Hospital, Tunja, Colombia.
¹⁴ Grupo de Trauma Ortopédico, Instituto de Ortopedia, Santa Casa de São Paulo, São Paulo, Brazil.
¹⁵ Department of Orthopaedic Surgery, Hospital Universitario de La Samaritana, Bogotá, Colombia.
¹⁶ Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
¹⁷ Department of Surgery, Center for Research in Longevity, Aging and Health, La Havana, Cuba.
¹⁸ Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Ortopedia, Clínica São Vicente, Rede D'Or São Luiz, Rio de Janeiro, Brazil.
¹⁹ Department of Trauma, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
²⁰ Department of Orthopaedic Surgery, University of California, Orthopaedic Trauma Institute, San Francisco School of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA.

PMID: 41098362
PMCID: PMC12519553
DOI: 10.1097/OI9.0000000000000437

Abstract

Rehabilitation after musculoskeletal trauma is globally acknowledged as essential for restoring function and improving quality of life; however, significant variation exists in rehabilitation frameworks and services worldwide. Although certain principles-such as early intervention, structured care pathways, and multidisciplinary approaches-are universally recognized as important determinants of outcomes in trauma patients, their implementation and effectiveness vary considerably due to differences in health care infrastructure, economic resources, policy frameworks, and cultural contexts. Drawing on comparative analyses of rehabilitation frameworks across regions, including North America, Latin America, Europe, Asia-Pacific, and Africa, this paper identifies structural variations, systemic challenges, and innovations that can inform global rehabilitation efforts. Strategic international collaboration focusing on shared learning, standardized protocols, technology integration, and targeted investments is key to creating equitable and sustainable rehabilitation models, especially in resource-limited settings and aging populations.

Keywords: global; musculoskeletal; rehabilitation; systems; trauma.

PubMed Disclaimer

References

1. Rossiter ND. Trauma-the forgotten pandemic? Int Orthop. 2022;46:3–11. - PMC - PubMed
1. Gimigliano F, Negrini S. The world health organization. Rehabilitation 2030: a call for action. Eur J Phys Rehabil Med. 2017;53:155–168. - PubMed
1. Stefanacci RG. Admission criteria for facility-based post-acute service. Ann Long-Term Care Clin Care Aging. 2015;23:18–20.
1. Beshiri R, Bollman RD, Canada S. Population Structure And Change In Predominantly Rural Regions. Vol 2; 2001. Available at: http://www.statcan.ca/cgi-bin/downpub/.
1. Lundy DW, Harvey EJ, Jahangir AA, et al. Trauma systems in North America. OTA Int. 2019;2(suppl 1):e013. - PMC - PubMed

LinkOut - more resources

Full Text Sources
- PubMed Central

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Musculoskeletal trauma rehabilitation: a global comparison

Affiliations

Musculoskeletal trauma rehabilitation: a global comparison

Authors

Affiliations

Abstract

References

LinkOut - more resources

Full Text Sources