Rehabilitation Definition for Research Purposes

Since its foundation, Cochrane Rehabilitation has faced challenges with rehabilitation definitions because existing definitions did not indicate what rehabilitation includes and what it excludes. We aimed to develop a comprehensive and shared rehabilitation definition for research purposes to: (1) support the conduct of primary studies and systematic reviews, and (2) identify relevant systematic reviews for knowledge translation purposes.

We performed a multimodal study including seven preliminary research and discussion papers, four Consensus Meetings, and three Delphi rounds with 80 rehabilitation stakeholders. The Delphi Study aimed to obtain agreement, refine and complete the items composing the definition and meanings of rehabilitation. These stakeholders covered 5 continents, representing 11 global and continental rehabilitation organizations, 11 scientific journals, 4 Cochrane Networks, and 3 Cochrane Groups, and included invited experts, and representatives of low middle-income countries and consumers.

We had a 70% to 82.5% response rate to the three Delphi rounds, during which participants responded to all items (100%) and provided relevant comments (range 5.5–50% per item). This participation led to several refinements to the rehabilitation definition through three preliminary versions, and the final items reached an agreement between 88.9% and 100%. We structured the definition using the PICO (Population, Intervention, Comparison, Outcome) framework.

We concluded that “In a health care context,” rehabilitation is defined as a “multimodal, person-centered, collaborative process” (Intervention-general), including interventions targeting a person’s “capacity (by addressing body structures, functions, and activities/participation) and/or contextual factors related to performance” (Intervention-specific) with the goal of “optimizing” the “functioning” (Outcome) of “persons with health conditions currently experiencing disability or likely to experience disability, or persons with disability” (Population). Rehabilitation requires that all the items of the definition are satisfied. We defined a “rehabilitation intervention” as “any intervention provided within the rehabilitation process.”

We developed a rehabilitation definition for research purposes achieving a broad agreement with global stakeholders. This definition provides explicit criteria to define rehabilitation. Using the proposed definition will improve rehabilitation research by standardizing the description of interventions. Our definition may require revision in the future, as further research enhances understanding and communication of the essence and complexity of rehabilitation.

Publication and links:

Rehabilitation Definition

Negrini S, Selb M, Kiekens C, Todhunter-Brown A, Arienti C, Stucki G, Meyer T; 3rd Cochrane Rehabilitation Methodology Meeting participants. Rehabilitation definition for research purposes. A global stakeholders' initiative by Cochrane Rehabilitation. Co-published in:

  • Eur J Phys Rehabil Med. 2022 Jun;58(3):333-341. PMID: 35306803. PubMed link
  • Neurorehabil Neural Repair. 2022 Jul;36(7):405-414. PMID: 35574944. PubMed link
  • Am J Phys Med Rehabil. 2022 Jul 1;101(7):e100-e107. PMID: 35583514; PMCID: PMC9197136. PubMed link

Preparatory papers

Negrini S, Levack WMM, Meyer T, Kiekens C. Why we need an internationally shared rehabilitation definition for clinical research purposes. Clin Rehabil. 2021 Dec;35(12):1657-1660. doi: 10.1177/02692155211043215. Epub 2021 Aug 31. PMID: 34461760. PubMed link
Kiekens C, Meyer T, Selb M, Stucki G, Negrini S. Authors' reply to: Comment on the provisory definition of the term "Rehabilitation". Eur J Phys Rehabil Med. 2021 Apr;57(2):316-317. doi: 10.23736/S1973-9087.21.06885-4. Epub 2021 Feb 23. PMID: 33619947. PubMed link
Negrini S, Arienti C, Küçükdeveci A, Lazzarini SG, Patrini M, Kiekens C. Current rehabilitation definitions do not allow correct classification of Cochrane systematic reviews: an overview of Cochrane reviews. Eur J Phys Rehabil Med. 2020 Oct;56(5):667-671. doi: 10.23736/S1973-9087.20.06585-5. Epub 2020 Sep 16. PMID: 32935959. PubMed link
Meyer T, Kiekens C, Selb M, Posthumus E, Negrini S. Toward a new definition of rehabilitation for research purposes: a comparative analysis of current definitions. Eur J Phys Rehabil Med. 2020 Oct;56(5):672-681. doi: 10.23736/S1973-9087.20.06610-1. Epub 2020 Sep 29. PMID: 32990687. PubMed link
Levack WM, Rathore FA, Negrini S. Expert opinions leave space for uncertainty when defining rehabilitation interventions: analysis of difficult decisions regarding categorization of rehabilitation reviews in the Cochrane library. Eur J Phys Rehabil Med. 2020 Oct;56(5):661-666. doi: 10.23736/S1973-9087.20.06615-0. Epub 2020 Sep 29. PMID: 32990688. PubMed link
Arienti C, Patrini M, Pollock A, Lazzarini SG, Oral A, Negrini S. A comparison and synthesis of rehabilitation definitions used by consumers (Google), major Stakeholders (survey) and researchers (Cochrane Systematic Reviews): a terminological analysis. Eur J Phys Rehabil Med. 2020 Oct;56(5):682-689. doi: 10.23736/S1973-9087.20.06583-1. Epub 2020 Oct 5. PMID: 33016065. PubMed link
Negrini S, Meyer T, Arienti C, Kiekens C, Pollock A, Selb M, Stucki G; 3rd Cochrane Rehabilitation Methodology Meeting participants. The 3rd Cochrane Rehabilitation Methodology Meeting: "Rehabilitation definition for scientific research purposes". Eur J Phys Rehabil Med. 2020 Oct;56(5):658-660. doi: 10.23736/S1973-9087.20.06574-0. Epub 2020 Sep 16. PMID: 32935957. PubMed link
Levack WMM, Rathore FA, Pollet J, Negrini S. One in 11 Cochrane Reviews Are on Rehabilitation Interventions, According to Pragmatic Inclusion Criteria Developed by Cochrane Rehabilitation. Arch Phys Med Rehabil. 2019 Aug;100(8):1492-1498. doi: 10.1016/j.apmr.2019.01.021. Epub 2019 Mar 2. PMID: 30831091. PubMed link

Infographic of the Rehabilitation Definition for research purposes