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1- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran, Shahrekord University of Medical Sciences
2- Department of Disasters and Emergencies, Community-Oriented Nursing Midwifery Research Center, Nursing and Midwifery School, Shahrekord University of Medical Sciences, Shahrekord, Iran ,mo.heydari@yahoo.com
3- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran., Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
2- Department of Disasters and Emergencies, Community-Oriented Nursing Midwifery Research Center, Nursing and Midwifery School, Shahrekord University of Medical Sciences, Shahrekord, Iran ,
3- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran., Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Abstract: (24 Views)
Background. Earthquakes can cause substantial injuries and long-term disabilities, particularly in low-resource settings where access to specialized rehabilitation is limited. Community-based rehabilitation (CBR) may help address these gaps by using local resources and improving access to rehabilitation services. However, the evidence regarding the role of CBR in improving functional, psychosocial, and social outcomes after earthquakes has not been systematically synthesized. Therefore, this systematic review asked: What evidence exists regarding the effectiveness, implementation characteristics, and barriers of CBR interventions for earthquake survivors, particularly in low- and middle-income countries (LMICs)?
Materials and Methods. This systematic review followed PRISMA guidelines. A comprehensive search of PubMed, ScienceDirect, Scopus, ProQuest, Web of Science, and Google Scholar identified 204 records published between January 2000 and July 2025 on CBR after earthquakes. After removing duplicates, screening titles and abstracts, and conducting full-text assessments based on predefined inclusion and exclusion criteria, we included nine studies in the final synthesis. We analyzed data using qualitative content analysis and appraised study quality with CASP for qualitative studies, STROBE‑adapted items for observational designs, and the JBI checklist for quasi‑experimental studies.
Results. Qualitative content analysis identified 11 major themes and 41 subthemes, encompassing functional and pain-related outcomes, psychosocial and social reintegration, locally adapted and resource-sensitive interventions, and implementation barriers and health-system constraints. Evidence for intervention effectiveness was limited by small samples, lack of control groups, heterogeneous designs, and reliance on descriptive reports. Post-traumatic stress disorder (PTSD) symptoms declined over time in one longitudinal cohort, but intervention-specific effects on PTSD could not be established.
Conclusion. Across the nine included studies, the most consistent signals concerned improved access to rehabilitation and within-group or longitudinal changes in pain, disability, mobility, and activities of daily living. However, the evidence for comparative intervention effectiveness was limited, particularly because some studies used small samples, lacked control groups, or were descriptive service reports. Evidence for psychosocial recovery and social reintegration was promising but inconsistently measured, and PTSD symptoms declined over time in one cohort without establishing an intervention-specific effect.
Materials and Methods. This systematic review followed PRISMA guidelines. A comprehensive search of PubMed, ScienceDirect, Scopus, ProQuest, Web of Science, and Google Scholar identified 204 records published between January 2000 and July 2025 on CBR after earthquakes. After removing duplicates, screening titles and abstracts, and conducting full-text assessments based on predefined inclusion and exclusion criteria, we included nine studies in the final synthesis. We analyzed data using qualitative content analysis and appraised study quality with CASP for qualitative studies, STROBE‑adapted items for observational designs, and the JBI checklist for quasi‑experimental studies.
Results. Qualitative content analysis identified 11 major themes and 41 subthemes, encompassing functional and pain-related outcomes, psychosocial and social reintegration, locally adapted and resource-sensitive interventions, and implementation barriers and health-system constraints. Evidence for intervention effectiveness was limited by small samples, lack of control groups, heterogeneous designs, and reliance on descriptive reports. Post-traumatic stress disorder (PTSD) symptoms declined over time in one longitudinal cohort, but intervention-specific effects on PTSD could not be established.
Conclusion. Across the nine included studies, the most consistent signals concerned improved access to rehabilitation and within-group or longitudinal changes in pain, disability, mobility, and activities of daily living. However, the evidence for comparative intervention effectiveness was limited, particularly because some studies used small samples, lacked control groups, or were descriptive service reports. Evidence for psychosocial recovery and social reintegration was promising but inconsistently measured, and PTSD symptoms declined over time in one cohort without establishing an intervention-specific effect.
Keywords: Community-Based Rehabilitation, Earthquakes, Disaster Response, Rehabilitation, Physical Therapy Modalities, Low-and Middle-Income Countries
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This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 (CC-By-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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