Priorities for research defined in collaboration with WHO rehabilitation programme

Questions on rehabilitation for COVID-19

This document comes from a Consensus among WHO rehabilitation programme and Cochrane Rehabilitation REH-COVER (Rehabilitation – COVID-19 Evidence-based Response) international multiprofessional Steering Committee.  The purpose is to offer the wider rehabilitation community a list of the research questions to be answered about COVID-19 and rehabilitation.

The document is organized in two parts. The first one includes a classification of the general expression “Limitations of functioning (disability) of rehabilitation interest” that is then used in the second part, as well as a subclassification of this same expression. All the following research questions should be answered according to these classifications. Ideally a research paper should state which kind of limitations of functioning (disability) of rehabilitation interest is evaluated, in which phase of rehabilitation and in which region of the world.

PART I. Classifications

The research questions should explore each of the following items

Limitations of functioning (disability) of rehabilitation interest Classification

The general expression "Limitations of functioning (disability) of rehabilitation interest" used in the following classification includes these terms (for their definition, refer to the WHO International Classification of Functioning, disability and health - ICF)

  1. Impairment(s)
  2. Activity limitation(s)
  3. Participation restriction(s)

Phases sub-classification

The limitations of functioning (disability) of rehabilitation interest are evaluated in different populations according to the different phases of rehabilitation. Each research question should be considered in each phase.

  1. Acute: limitations of functioning (disability) of rehabilitation interest during COVID-19 infection
  2. Post-acute: limitations of functioning (disability) of rehabilitation interest continuing from the acute phase of COVID-19 and its treatment
  3. Permanent: limitations of functioning (disability) of rehabilitation interest unresolved or not solvable, and causing a new health condition
  4. Late-onset: limitations of functioning (disability) of rehabilitation interest appeared as a consequence of COVID-19 but after the end of the acute phase
  5. Acute, post-acute, late-onset, or permanent new limitations of functioning (disability) of rehabilitation interest on a pre-existing health condition: impact of COVID-19 on people with disability and/or experiencing disability at the time of infection

Regions of the world sub-classification

The limitations of functioning (disability) of rehabilitation interest could be different, as well as the answers, in the different regions of the world. Consequently the research questions should consider the following.

  1. High Income Countries
  2. Low and Middle Income Countries

PART II. Research questions

Epidemiology of limitation of functioning (disability) of rehabilitation interest due to COVID-19

  1. What are the limitations of functioning (disability) of rehabilitation interest?
  2. Which is the clinical presentation (sign, symptoms, diagnostic exam) of the limitations of functioning (disability) of rehabilitation interest?
  3. What is the prevalence of the limitations of functioning (disability) of rehabilitation interest?
  4. What is the natural history of the limitations of functioning (disability) of rehabilitation interest?
  5. What are the determining factors of the limitations of functioning (disability) of rehabilitation interest and how they influence possible changes of the limitations of functioning (disability) of rehabilitation interest? [including virus (etiology),
    Demographics, Health (co-morbidities), Acute treatments, Clinical presentation (interaction between limitation(s) of functioning)]

Evidence on rehabilitation for limitations of functioning (disability) of rehabilitation interest due to COVID-19 at the individual level (micro-level)

  1. What is the evidence on the type of outcomes for limitations of functioning (disability) of rehabilitation interest? (i.e. outcomes to be considered when treating limitations of functioning (disability) of rehabilitation interest)
  2. What is the evidence on effect of interventions for limitations of functioning (disability) of rehabilitation interest?
  3. What is the evidence on side-effects/harms/disadvantages of interventions for limitations of functioning (disability) of rehabilitation interest?
  4. What is the evidence on cost-effectiveness of interventions for limitations of functioning (disability) of rehabilitation interest?

Evidence on rehabilitation for limitations of functioning (disability) of rehabilitation interest due to COVID-19 at service level (meso-level)

  1. What is the evidence on accessibility (availability, access, utilization) to services for limitations of functioning (disability) of rehabilitation interest due to COVID-19?
  2. What is the evidence on workforce and/or technology requirements for addressing limitations of functioning (disability) of rehabilitation interest due to COVID-19?
  3. What is the evidence on changes to the provision of rehabilitation services as a consequence of the pandemic?

Evidence on rehabilitation for limitations of functioning (disability) of rehabilitation interest due to COVID-19 at system level (macro-level)

  1. What is the evidence on the need of services for limitations of functioning (disability) of rehabilitation interest due to COVID-19?
  2. What is the evidence on financing of services for limitations of functioning (disability) of rehabilitation interest due to COVID-19?
  3. What is the evidence on health systems requirements for limitations of functioning (disability) of rehabilitation interest due to COVID-19?
  4. What is the evidence on regulation of delivery of services for limitations of functioning (disability) of rehabilitation interest due to COVID-19?
  5. What is the evidence on changes on the health systems related to rehabilitation as a consequence of the pandemic?