Results Summary

What was the research about?

Many people have health problems that affect how well they can do normal activities, either for a short time or for their lifetime. These problems may be present from birth or result from illness, injury, or aging. Rehabilitation, or rehab, can help patients regain the ability to do normal activities. Rehab providers include doctors, nurses, psychologists, and physical, occupational, speech, or language therapists.

Rehab treatments often lack a common definition. Rehab providers often name treatments by the type of professional who delivers them or the problem they treat, rather than by the content of the treatment. Also, treatments can vary across rehab providers. Using a standard way to define rehab treatments may help researchers compare these treatments.

In this study, the research team created and tested a manual to help rehab providers use standard ways to define rehab treatments.

What were the results?

The manual included three types of treatments:

  • Body functions. These treatments focus on making a body part work better, such as helping someone increase their grip strength or bend their knees.
  • Skills and habits. These treatments focus on helping people get better at doing something that needs practice, such as walking.
  • Representations. These treatments focus on thoughts, feelings, and knowledge. An example might be helping someone learn about what puts them at risk for falling.

The manual also described two parts for each rehab treatment: targets and ingredients. A target is the specific functional problem that the patient has, such as trouble walking fast. Ingredients are the things that make up a treatment, such as activities, procedures, or medicines that may help the patient. The manual explained how providers can describe types of treatments, targets, and ingredients.

Because the manual was complex, rehab providers needed more than one training session to learn how to use it.

What did the research team do?

The research team held group discussions with rehab providers about rehab treatments. The team used this information to identify common rehab needs people might have. Then the team came up with a process for how to define rehab treatments. When members of the team didn’t agree on how to define a treatment, they talked it over and came up with a solution together. The team then wrote a manual about how to define rehab treatments, targets, and ingredients.

When a draft of the manual was ready, the research team trained a group of 40 rehab providers from around the country on how to use it. After the training, the providers gave the team feedback about the manual.

An advisory board of rehab providers, educators, researchers, and patients helped the research team plan and conduct the study.

What were the limits of the study?

The research team discussed many but not all types of rehab treatments. The manual may not help describe every possible treatment.

Future research could continue to improve the manual and develop ways to train rehab providers to use it.

How can people use the results?

Using a standard way to define rehab treatments may help researchers compare treatments in the future.

Final Research Report

View this project's final research report.

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented, and the researchers made changes or provided responses. The comments and responses included the following:

  • Reviewers asked for additional context on how the rehabilitation treatment taxonomy this study described relate to World Health Organization-defined classification systems for rehabilitation services. In particular, they wanted more on this taxonomy’s place in the broader field of treatment characterization. The researchers responded that they had critically analyzed the degree to which the World Health Organization systems can address the requirements of the kind of system for specifying treatments that their research addressed. The researchers expressed that they did not feel the World Health Organization systems were adequate in several areas, for example, because of inflexibility in timetables. The researchers said they believe their taxonomy has value in both research and clinical settings. They also said they have received enough enthusiastic feedback to believe development of their taxonomy deserves to continue.
  • Reviewers said the use of the word, ingredients, throughout the text was confusing. The researchers said that they used the word because clinicians are familiar with the concept of active ingredients. The researchers added a miniglossary to the appendix.
  • Reviewers asked for additional information on the many clinicians involved in training and testing. The researchers added a table and additional text about clinician participants. The researchers also added to the description of how they recorded, processed, and implemented feedback from various audiences.

Conflict of Interest Disclosures

Project Information

John Whyte, MD, PhD
Albert Einstein Healthcare Network
$912,199
10.25302/02.2020.140314083
Better Rehabilitation Through Better Characterization of Treatments: Development of the Manual for Rehabilitation Treatment Specification

Key Dates

September 2014
December 2018
2014
2018

Study Registration Information

Tags

Has Results
Award Type
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: April 11, 2024