Nhv Rehabilitation Management Mode Of The 2008 Sichuan Earthquake Victims, The Effects Of Daily Life Activities

Background: The2008Sichuan earthquake in the People’s Republic of Chinaresulted in more than10,000severely injured victims. The emergency response tomeet victims’ medical rehabilitation needs was challenged by degraded medicalinfrastructure, scarcity of rehabilitation professionals, and inadequate funding.Consequently, a collaborative rehabilitation management model consisting ofnon–governmental organizations (NGOs), health departments and rehabilitationvolunteers (NHV rehabilitation management model) was established.Aims: To evaluate the effectiveness of rehabilitation intervention on activities ofdaily living (ADLs) demonstrated using the NHV rehabilitation management model.Methods: Five hundred and ten earthquake survivors from three largely destroyedareas were enrolled in this quasi–experimental study. The first intervention group(early intervention group; NHV–E group) consisted of298survivors who receivedhospital–based rehabilitation; the second intervention group (late intervention group;NHV–L group) was comprised of101survivors who received rehabilitation one yearlater. The control group consisted of111earthquake survivors who did not receivehospital–based rehabilitation. Functioning and disability were assessed with theBarthel Index (BI), a measure of independence in activities of daily living. Mixedeffects Tobit regression was performed to analyze the data. Counterfactualpredictions setting the rehabilitation effect to zero were compared with our modelestimation in order to disentangle effects of rehabilitation and spontaneous recovery.Results: ADLs were significantly improved in the NHV–E and NHV–L groups at follow-up compared with baseline but not in the control group after adjustment forgender, age, type of injury, and time to measurement. Our model estimation showssignificant effects of both rehabilitation and time to measurement point with agreater effect of rehabilitation. According to our fully adjusted model estimation theNHV rehabilitation management model improved ADL by a clinical meaningfulscore of11points on average.Conclusion: The NHV rehabilitation management model appears effective inimproving ADL of earthquake survivors. It may thus be applied in futurerehabilitation disaster relief efforts.