Medical rehabilitation of spinal cord injury following earthquakes in rehabilitation resource-scarce settings: implications for disaster research.

STUDY DESIGN: Narrative literature review. OBJECTIVES: To (1) summarize epidemiological and scientific research on spinal cord injury (SCI) populations from three severe earthquakes (EQs) in rehabilitation resource-scarce settings; (2) summarize SCI rehabilitation services by local and foreign providers in response to these EQs and (3) provide implications including research gaps for a supporting global scientific research agenda. SETTING: International. METHODS: A literature review was conducted using PubMed to identify epidemiological studies reporting data on SCI survivors of the 2005 Kashmir EQ in Pakistan, the Sichuan EQ of 2008 in China and the 2010 Haiti EQ. A follow-up review on the SCI rehabilitation services provided by local and foreign providers in response to these EQs was also performed. RESULTS: Review of the scientific literature revealed the qualitative trends in focused EQ victim epidemiological data, including SCI classification and types of medical complications. Selected EQ country narratives showed that post-disaster SCI rehabilitation services were expanded by adapting local resources with international assistance to manage the significant numbers of SCI survivors. The resulting SCI research was limited. CONCLUSION: A global disaster research agenda for SCI in EQs in rehabilitation resource-scarce settings is needed to strengthen the evidence base for improvement of clinical management and outcomes for SCI EQ survivors. Expansion of this limited narrative review into a systematic review to identify additional research gaps is a proposed next step. Effective disaster setting data management and research collaborations of foreign and local SCI disability and rehabilitation stakeholders will be required for agenda implementation.

ISCoS-WHO collaboration. International Perspectives of Spinal Cord Injury (IPSCI) report.

OBJECTIVE: The objective of this study was to describe the projects, the International Spinal Cord Society (ISCoS) has in cooperation with the World Health Organization (WHO) for the benefit of individuals with spinal cord injury (SCI) worldwide. SETTING: International METHODS: Collaboration between ISCoS and WHO can be divided into (A) building capacity for better SCI education and prevention programs; (B) improving classification systems for use of data in SCI research, the International Classification of External Cause of Injury (ICECI), the International Classification of Diseases (ICD) and the International Classification of Functioning, Disability and Health (ICF); and (C) improving the evidence base for SCI through the report, International Perspectives on Spinal Cord Injury (IPSCI). The objectives of the IPSCI report are first to summarize information on SCI, in particular the science and epidemiology, the services, interventions and policies that are relevant and 'the lived experience' of persons with SCI across the full spectrum of life and throughout the world; second, to document all aspects of the science and experience of SCI to identify gaps between what exists and what is required; and third to make recommendations based on this evidence, with a clear perception of feasible goals and targets, that are consistent with the aspirations and goals of inclusion and full participation as expressed in the UN Convention of the Rights of Persons with Disabilities. FUTURE COOPERATION: ISCoS and WHO will continue to join forces in areas where they can make the greatest difference, especially in prevention and educational issues worldwide.