Global estimates show one third of the population may benefit from rehabilitation services

 1. Approximately 1 in every 3 people worldwide (2.41 billion) could benefit from rehabilitation services with the Western Pacific region having the greatest need.

2. Musculoskeletal disorders contributed most to the need for rehabilitation with lower back pain identified as the most prevalent condition globally.

Evidence Rating Level: 3 (Average)

Study Rundown: Worldwide, life expectancy is increasing with greater numbers of individuals living with non-communicable diseases. Rehabilitation services are important to improve functional ability, maintain independence and improve quality of life. However, rehabilitation services are under-utilized worldwide, often due to limited funding or misconceptions about its utility. This systematic analysis applied data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 to estimate the prevalence and years of life affected by 25 diseases or impairments amenable to rehabilitation services. Results suggested that 2.41 billion people or approximately 1/3^rd of the global population would benefit from rehabilitation services with the Western Pacific region having the highest overall need for rehabilitation services. Musculoskeletal disorders were found to be the greatest contributor to the prevalence of diseases requiring rehabilitation with low-back pain being the most prevalent condition in 134 of 204 countries analyzed. This study was limited by the lack of primary data from all countries included in the study, resulting in estimations based on geographical proximity to countries with data. Additionally, the 25 conditions including in the analysis were selected based on need for rehabilitation at any point in the disease course and therefore, not all 2.41 billion people may necessarily require rehabilitation services at the time of the study. Nonetheless, the results of this study make a strong case for the increased need for rehabilitation services with an argument for these services to be strengthened and sufficiently funded at the primary care level.

Click to read the study in The Lancet

Relevant Reading: Five insights from the Global Burden of Disease Study 2019

In-Depth [cross-sectional study]: This systematic analysis utilized data obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 to estimate the global need for rehabilitation based on the prevalence and years of life lived with disability of 25 diseases or conditions amenable to treatment with rehabilitation. Health conditions included in the analysis were selected based on years lost due to disability, exclusion of conditions for which rehabilitation was not deemed essential and based on recommendations from experts in the field of rehabilitation convened by the WHO. Analyses were done at the country level before data was aggregated into 7 WHO regions (World Bank high income countries, Africa, the Americas, Europe, Southeast Asia, Eastern Mediterranean and Western Pacific).

Overall, 2.41 billion individuals (95% uncertainty interval [UI] 2.34 to 2.50) had conditions that would benefit, at some point in the disease course, from rehabilitation services contributing to a total of 310 million years of life lived with disability (95% UI 235 to 392). The prevalence was roughly equivalent amongst men (1.19 billion, 95% UI 1.15 to 1.23) and women (1.22 billion, 95% UI 1.18 to 1.27) despite women having more years of life lived with disability (163 million, 95% UI 124 to 206) compared to men (146 million, 95% UI 110 to 186). Among the WHO regions, the Western Pacific had the highest need for rehabilitation services (610 million people, 95% UI 588 to 636) followed by Southeast Asia, World Bank high income countries, Europe, the Americas, Africa and the Eastern Mediterranean (182 million people, 95% UI 174 to 192). Musculoskeletal disorders had the greatest contribution to prevalence with 1.71 billion individuals (95% UI 1.63 to 1.80) affected and 149 million years of life lived with disability (95% UI 108 to 199) worldwide. Of these musculoskeletal disorders, low back pain had the highest disease burden with 568 million people affected (95% UI 505 to 640) and 64 million years of life lived with disability (95% UI 45 to 85).

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