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The NHV Rehabilitation Services Program Improves Long-Term Physical Functioning in Survivors of the 2008 Sichuan Earthquake: A Longitudinal Quasi Experiment

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  • Xia Zhang
  • Jan D Reinhardt
  • James E Gosney
  • Jianan Li

Abstract

Background: Long-term disability following natural disasters significantly burdens survivors and the impacted society. Nevertheless, medical rehabilitation programming has been historically neglected in disaster relief planning. ‘NHV’ is a rehabilitation services program comprised of non–governmental organizations (NGOs) (N), local health departments (H), and professional rehabilitation volunteers (V) which aims to improve long-term physical functioning in survivors of the 2008 Sichuan earthquake. We aimed to evaluate the effectiveness of the NHV program. Methods/Findings: 510 of 591 enrolled earthquake survivors participated in this longitudinal quasi-experimental study (86.3%). The early intervention group (NHV–E) consisted of 298 survivors who received institutional-based rehabilitation (IBR) followed by community-based rehabilitation (CBR); the late intervention group (NHV–L) was comprised of 101 survivors who began rehabilitation one year later. The control group of 111 earthquake survivors did not receive IBR/CBR. Physical functioning was assessed using the Barthel Index (BI). Data were analyzed with a mixed-effects Tobit regression model. Physical functioning was significantly increased in the NHV–E and NHV–L groups at follow-up but not in the control group after adjustment for gender, age, type of injury, and time to measurement. We found significant effects of both NHV (11.14, 95% CI 9.0–13.3) and sponaneaous recovery (5.03; 95% CI 1.73–8.34). The effect of NHV-E (11.3, 95% CI 9.0–13.7) was marginally greater than that of NHV-L (10.7, 95% CI 7.9–13.6). It could, however, not be determined whether specific IBR or CBR program components were effective since individual component exposures were not evaluated. Conclusion: Our analysis shows that the NHV improved the long-term physical functioning of Sichuan earthquake survivors with disabling injuries. The comprehensive rehabilitation program benefitted the individual and society, rehabilitation services in China, and international rehabilitation disaster relief planning. Similar IBR/CBR programs should therefore be considered for future large-scale rehabilitation disaster relief efforts.

Suggested Citation

  • Xia Zhang & Jan D Reinhardt & James E Gosney & Jianan Li, 2013. "The NHV Rehabilitation Services Program Improves Long-Term Physical Functioning in Survivors of the 2008 Sichuan Earthquake: A Longitudinal Quasi Experiment," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-10, January.
    • Handle: RePEc:plo:pone00:0053995
    DOI: 10.1371/journal.pone.0053995
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    Cited by:

    1. James Smith & Bayard Roberts & Abigail Knight & Richard Gosselin & Karl Blanchet, 2015. "A systematic literature review of the quality of evidence for injury and rehabilitation interventions in humanitarian crises," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(7), pages 865-872, November.
    2. Ashrita Saran & Howard White & Hannah Kuper, 2020. "Evidence and gap map of studies assessing the effectiveness of interventions for people with disabilities in low‐and middle‐income countries," Campbell Systematic Reviews, John Wiley & Sons, vol. 16(1), March.
    3. Joseph Kimuli Balikuddembe & Xinglin Zeng & Chuandong Chen, 2020. "Health-Related Rehabilitation after the 2008 Great Wenchuan Earthquake in China: A Ten Year Retrospective Systematic Review," IJERPH, MDPI, vol. 17(7), pages 1-17, March.

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