02431nas a2200205 4500000000100000008004100001260001200042653001900054653002000073653001800093653003500111653001500146100001200161700001400173700001300187700001300200245010800213520189000321022001402211 2020 d c02/202010aRehabilitation10aHealth Services10aGlobal health10aGlobal Burden of Disease study10aDisability1 aJesus T1 aLandry MD1 aBrooks D1 aHoenig H00aPhysical rehabilitation needs per condition type: Results from the Global Burden of Disease study 2017.3 a

OBJECTIVE: To determine how total physical rehabilitation needs have been distributed per relevant condition groups (musculoskeletal & pain, neurological cardiothoracic, neoplasms, pediatric, and HIV-related), globally and across countries of varying income level.

DESIGN: Sub-group, secondary analyses of data from the Global Burden of Disease 2017. Data for the year 2017 are used for determining current needs, and data from every year between 1990 and 2017 for determining changing trends.

SETTINGS: Globally and High, Upper Middle, Lower Middle, and Low-Income countries.

PARTICIPANTS: Not applicable INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURE: Years Lived with Disability per 100,000 people (YLD Rates) for the 6 condition groups.

RESULTS: In 2017, musculoskeletal & pain conditions accounted for 52.6% of the total physical rehabilitation needs worldwide; HIV-related for 5.7% of the physical rehabilitation needs in low-income nations, but about 1% in all other locations. Worldwide, significant increases in YLD Rates were observed since 1990 for the 6 condition groups (p<0.01). However, across country types, we observed significant decreases in YLD Rates for specific conditions: pediatric in high-income countries, and neurological and neoplasm conditions in low-income (p<0.01). In upper middle-income countries, YLD Rates from neurological and neoplasm conditions grew exponentially since 1990, with overall increases of 67% and 130%, respectively.

CONCLUSION: At a global scale, physical rehabilitation needs per-capita are growing for all major condition groups, with musculoskeletal & pain conditions currently accounting for over half of those needs. Countries of varying income level have different typologies and evolutionary trends in their rehabilitation needs.

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