A comparison and synthesis of rehabilitation definitions used by consumers (Google), major Stakeholders (survey) and researchers (Cochrane Systematic Reviews): a terminological analysis

Abstract

BACKGROUND: The term "rehabilitation" is heterogeneously used in the health context. Different interpretations can lead to disagreements, misunderstandings and different interpretations of what rehabilitation is between who provides it, who receives it and who studies it. The aim of this study was to conduct a terminological analysis of the different rehabilitation definitions used by different audiences: consumers, rehabilitation stakeholders and researchers. METHODS: We performed a terminological analysis with comparison of three different collections of rehabilitation definitions in English language. We performed: systematic reviews of databases representing consumers and lay persons (Google) and researchers (Cochrane Systematic Reviews [CSRs]), and a survey of rehabilitation stakeholders (Cochrane Rehabilitation Advisory Board). To aggregate words that had the same underlying concepts, their roots were extracted, and their occurrences counted. The 30 most frequent roots of each search were included. The 3 obtained collections were compared and similarities calculated. An overall collection of the most important 30 roots was obtained weighting those obtained in each single collection. All analyses have been performed using Excel. RESULTS: One hundred and eighty-seven rehabilitation definitions were identified: 23 from CSRs, 36 from the survey and 128 from Google. The most frequent roots were "function*" (92%), followed by "proces*" (69‰), "health*" (59‰), "disab*" (53‰), and "person*" (50‰). The most common relevant roots related to rehabilitation concept were "proces*" (73‰) in Google, "function*" (109‰) in the survey and "disab*" (41‰) in CSRs. The noun "function" prevailed in Google and "functioning" in the survey. CONCLUSIONS: According to our findings, any definition of rehabilitation for research purposes should include the identified terms, focusing on the concept of process and considering the main elements of functioning (and function), disability, person, health, optimization and environment.

Current evidence from the Randomized Controlled Trials Rehabilitation Checklist (RCTRACK) reporting guideline project

“…Overall, these 3 special sections provide a comprehensive overview of the problems in the reporting of RCTs in rehabilitation as presented during the 4 th Cochrane Rehabilitation Methodology Meeting. Together with the articles on the new definition of rehabilitation for scientific research purposes (10,(22)(23)(24)(25)(26), these studies offer the scientific background of the RCTRACK project and guidelines. During the RCTRACK Consensus Meeting, the first draft of 2 guidelines was prepared.…”

Why we need an internationally shared rehabilitation definition for clinical research purposes

“…1,3 However, they do not allow what research needs: classifying what is and what is not rehabilitation. [2][3][4][5]7 For this reason, in 2019, Cochrane Rehabilitation launched its 'rehabilitation definition for research purposes' project 2 that is now coming to an end.…”

“…Several definitions and conceptual descriptions of rehabilitation exist. 3 Some are popular among consumers, 4 others among professionals 3 and researchers, 5 who mainly refer to the most important international agencies, like the World Health Organization (WHO). 6 Some are synthetic and simple, 4 others comprehensive but also complicated.…”

“…3 Some are popular among consumers, 4 others among professionals 3 and researchers, 5 who mainly refer to the most important international agencies, like the World Health Organization (WHO). 6 Some are synthetic and simple, 4 others comprehensive but also complicated. 1,3 However, they do not allow what research needs: classifying what is and what is not rehabilitation.…”

“…This is precisely the process that Cochrane Rehabilitation decided to follow to improve the current situation around the definition of rehabilitation. We began with some basic research [3][4][5]7 followed by a qualitative consensus development process 1 to achieve the first version of a definition of rehabilitation for research purposes, which can now be taken forward for testing by scientists worldwide.…”