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Background: Chikungunya fever is an arboviral disease, caused by an alphavirus, the Chikungunya virus, characterized by fever and joint pain that is generally disabling in the acute phase and may last from months to years, with the potential to evolve into chronic musculoskeletal symptoms, as polyarthralgia and arthritis, which can lead to significant impairment of physical function. The non-pharmacological treatment is very important for these patients, and resistance exercises may be one rehabilitation option., Aim: This study aimed to evaluate the efficacy of a resistance exercise protocol on the physical function, pain, and quality of life of patients with chronic Chikungunya fever., Design: A randomized, controlled, blind trial for the evaluators., Setting: Clinic-school of Physical therapy., Population: Thirty-one patients with Chikungunya fever and musculoskeletal symptoms lasting more than three months, recruited from the Rheumatology outpatient clinic at Clinical Hospital, Federal University of Pernambuco (HC-UFPE)., Methods: Patients (aged 56±10 years) were randomly assigned into one of two groups: Resistance Exercise Group (REG, N.=15) or Control Group (CG, N.=16). REG performed progressive resistance exercises with elastic bands (24 sessions over 12 weeks). CG only had their symptoms monitored through phone calls, maintaining the usual care treatment. Assessments were taken at baseline and after 6 and 12 weeks of the following: physical function (30-second Chair Stand Test (30-s CST), 4-step Stair Climb Power Test (4SCPT), 40-m Fast-paced Walk Test (40m FPWT), and Disabilities of the Arm, Shoulder, Hand (DASH) questionnaire); pain (VAS and painful joints count); quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36]); and Patient Global Impression of Change (PGIC) scale., Results: There was a reduction of pain (P=0.01; d=-0.83) and an improvement of 30-s CST (P=0.04; d=0.85) in REG participants after 12 weeks. There was no significant change in the domains of SF-36. Nearly 70% of trained patients reported improvement on PGIC., Conclusions: Resistance exercises improved physical function in sitting and standing and reduced pain in patients with chronic Chikungunya fever., Clinical Rehabilitation Impact: Resistance exercises can be considered as a treatment approach for patients with musculoskeletal disorders in the chronic stage of Chikungunya fever.

Background: An accurate diagnosis of the leading health condition and comorbidities is a prerequisite for safe and effective rehabilitation. The problem of diagnostic errors in physical and rehabilitation medicine (PRM) has not been addressed sufficiently. The responsibility of a referring physician is to determine indications and contraindications for rehabilitation., Aim: To assess the rate of and risk factors for inaccurate referral diagnoses (RD) in patients referred to a rehabilitation facility. We hypothesized that inaccurate RD would be more common in patients: 1) referred by non-PRM physicians; 2) waiting longer for the admission; 3) older patients., Design: Retrospective observational study., Population: One thousand randomly selected patients admitted between 2012 and 2016 to a day-rehabilitation center (DRC)., Setting: University DRC specialized in musculoskeletal diseases., Methods: On admission all cases underwent clinical verification of RD. Inappropriateness regarding primary diagnoses and comorbidities were noted. Influence of several factors affecting probability of inaccurate RD was analyzed with multiple binary regression model applied to 6 categories of diseases., Results: The rate of inaccurate RD was 25.2%. Higher frequency of inaccurate RD was noted among patients referred by non-PRM specialists (30.3% vs. 17.3% in cases referred by PRM specialists). Application of logit regression showed highly significant influence of the specialty of a referring physician on the odds of inaccurate RD (joint Wald Test χ2 (6)=38.98, P value =0.000), controlling for the influence of other variables. This may reflect a suboptimal knowledge of the rehabilitation process and a tendency to neglect of comorbidities by non-PRM specialists. The rate of inaccurate RD did not correlate with time between referral and admission (joint Wald Test of all odds ratios equal to 1, χ2 (6)=5.62, P value =0.467), however, mean and median waiting times were relatively short (35.7 and 25 days respectively). A high risk of overlooked multimorbidity was revealed in elderly patients (all odds ratios for variable age significantly higher than 1). Hypotheses 1 and 3 were confirmed., Conclusions: Over 25% of patients referred to DRC had inaccurate RD. Risk factors for inaccurate RD include referral by a non-PRM specialist and elderly age., Clinical Rehabilitation Impact: Verification of RD should be routinely introduced to PRM practice.

Introduction: Musculoskeletal disorders (MSDs) are a burden on the healthcare system. Exercise therapy is an important part of MSD rehabilitation. Motion detection systems are developed to support exercise therapy settings. This systematic review aimed: 1) at investigating which types of motion detection systems have been used as a technological support for exercise therapy; 2) at investigating the characteristics of motion detection supported exercise therapy in relation to its clinical indications; and 3) at evaluating the effectiveness of motion detection supported exercise therapy, in MSD rehabilitation., Evidence Aqcuisition: A systematic literature search for RCTs was performed in six databases (PubMed, CINAHL, EMBASE, ACM, Cochrane, and IEEE). Studies eligible for inclusion had to evaluate exercise therapy for persons with MSDs, provide a motion detection system capable of as well measuring active movement of the participant during exercise therapy as evaluating the movement in order to provide qualitative feedback, and should present at least one measure of the following ICF function (pain, muscle strength, mobility), activity (disease-related functional disability, balance) or participation (quality of life) level. Two reviewers independently screened articles, appraised study quality, extracted data, and evaluated effectiveness of selected outcome measures. This review was registered in the International prospective register of systematic reviews (Prospero) under registration number CRD42016035273., Evidence Synthesis: Nine RCTs (N.=432 participants) were included. Eight different motion detection technologies were used such as an accelerometer, gyroscope, magnetometer etc. All systems provided visual feedback. Knee disorders were evaluated most frequently, followed by low back pain and shoulder disorders. Therapy consisted of mobility, balance or proprioception exercises. Main outcomes were pain, disability, mobility and muscle strength. Motion detection supported exercise therapy showed similar or enhanced results on all outcomes compared to conventional exercise therapy. However, a limitation of this study was the low methodological quality of the studies., Conclusions: To date, a variety of motion detection systems have been developed to support the rehabilitation of MSDs. Results show similar effectiveness of motion detection supported exercise therapy compared to conventional exercise therapy. More research is needed to provide insight in the added value of motion detection systems in musculoskeletal rehabilitation.

Since his launch Cochrane Rehabilitation has started working to be a bridge between Cochrane and rehabilitation. After a fist period of work organization, the field has started producing actions through its committees: communication, education, methodology, publication and reviews. All the results of this first year of activity are listed in this report.

The translation of scientific knowledge into clinical practice is still not consistently achieved and the Cochrane Knowledge Translation (KT) Strategy, has been developed in response to this issue, as key step in moving from knowledge to action. "Blogshots" are a new means of presenting evidence in a way that can be easily accessed and understood. They are a form of infographic, which presents key information from a Cochrane Reviews. Cochrane Rehabilitation has begun to produce blogshots of Cochrane Reviews relevant to rehabilitation in collaboration with Cochrane UK and others within Cochrane, as one of knowledge translation activity performed by the field.

Background: Rehabilitation patients, without brain damage, sometimes complain about poor concentration and problems with their memory. The magnitude and associations, of this cognitive dysfunction, with different factors is unclear., Aim: To determine the magnitude of cognitive dysfunction in rehabilitation outpatient and to explore its associations with patient characteristics, diagnosis, surgery, pain, stress, anxiety and depression., Design: Cross-sectional., Setting: Rehabilitation outpatients., Population: Between July 2009 and January 2012, 274 rehabilitation outpatients were included and divided in 8 different groups through diagnosis., Methods: Cognitive functioning was assessed using the cognitive failure questionnaire and compared with the general Dutch population. Associations of gender, age, diagnosis, recent surgery, pain and stress coping ability with cognitive function was explored. Mediation of depression and anxiety was explored., Results: The rehabilitation patients had a significantly higher score on the CFQ (mean 35.9±13.4) when compared to the general Dutch population (mean 31.8±11.1). Mean difference is 4.1, 95% confidence interval 2.60 to 5.60. In the stepwise linear regression analysis only gender, diagnosis and stress coping ability were significantly associated. A significant mediation effect was found of anxiety (P≤0.001) and depression (P≤0.005) between stress coping ability and cognitive function., Conclusions: Rehabilitation outpatients experience more cognitive problems in comparison to the general Dutch population. Reported dysfunction of cognition in rehabilitation outpatients are associated with stress coping ability and for a small amount to gender and diagnosis. The association of stress coping ability and cognitive dysfunction is mediated by depression and anxiety. Women tend to report more dysfunctional cognition compared to men. Patient characteristics, surgery and experienced pain have no significant influence on the experienced cognitive dysfunction., Clinical Rehabilitation Impact: Cognitive problems reported by patients should be addressed by adapting the rehabilitation program, for instance write down instructions, repeat explanations and take more time for instructions. Cognitive problems in rehabilitation patients without brain damage is probably a stress coping problem and can be addressed by boosting resilience. Targeting depression or anxiety is another option of treatment cognition if those are mediating between stress coping and cognitive problems.

Background: Musculoskeletal sonography use in point-of-care physical medicine and rehabilitation is rapidly expanding, not only by physiatrists, but also by non-physician rehabilitation providers., Aim: The aim of the present review was to evaluate the current range, extent and nature of the related literature and to identify emerging areas of evidence for the use of musculoskeletal sonography involving non-physician rehabilitation providers to guide research and clinical practice., Design: Scoping review., Setting: Inpatient, outpatient, other., Population: Musculoskeletal conditions., Methods: Five databases were searched and 578 unique abstracts were identified and screened for eligibility. Three raters independently read 68 full texts, and 36 articles that reported on applied uses of sonography by non-physician rehabilitation providers were included., Results: Eighteen studies described direct clinical use, primarily for outcomes measurement (N.=12) or as a biofeedback intervention (N.=10). Twelve laboratory studies were included that related morphology to patient reports or validated clinical interventions. Six additional studies, although not involving non-physician providers, were included as they presented potential valuable uses that were not noted in the other included studies, such as monitoring bone healing, tendon repair, and evaluation of idiopathic symptom reports or non-specific primary diagnoses., Conclusions: This review indicates that non-physician rehabilitation providers use sonography for outcomes measurement and biofeedback interventions. Research is needed to evaluate effects of these uses on patient outcomes and to explore additional potential uses for clinical reasoning, treatment planning, and monitoring of tissue healing related to intervention., Clinical Rehabilitation Impact: Implementation of musculoskeletal sonography by non-physician rehabilitation providers has the potential to be a critically advantageous addition to improve care.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned ankle/foot structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned knee structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned hip structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned shoulder structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned elbow structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned wrist/hand structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.

Currently the application of shock wave therapy (SWT) in musculoskeletal disorders has been primarily used in the treatment of tendinopathies (proximal plantar fasciopathy, lateral elbow tendinopathy, calcific tendinopathy of the shoulder, and patellar tendinopathy, etc.) and bone defects (delayed- and non-union of bone fractures, avascular necrosis of femoral head, etc.). Although the mechanism of their therapeutic effects are still unknown, the majority of published papers have shown positive and beneficial effects of using SWT as a treatment for musculoskeletal disorders, with a success rate ranging from 65% to 91%, while the complications are low or negligible. The purpose of this paper is to inform the reader about the published data on the clinical application of SWT in the treatment of musculoskeletal disorders. In this paper, with the help of a literature review, indications and success rates for SWT in the treatment of musculoskeletal disorders are outlined, while adequate SWT parameters (e.g., rate of impulses, energy flux density, etc.) are defined according to the present state of knowledge.

One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of the physical and rehabilitation medicine interventions. According to the UEMS-PRM section, the role of PRM physician in musculoskeletal perioperative settings has to be situated inside general pain management. Musculoskeletal surgery (MSS) represents a frequent medical situation among patients suffering from musculoskeletal disorders (MSDs), in which PRM physicians need to be involved. A wide number of MSDs have to be operated in order to diminish disability and relieve symptoms, thus improving the patient´s functioning and social participation: Joint replacements, spine decompressions, vertebroplasties, internal fixation of unstable fractures, arthroscopies for tendon and joint repairs, and others. This paper describes the role of the PRM physician during the perioperative period. A well-coordinated rehabilitation programme followed by a good home rehabilitation programme results in pain reduction, faster recovery with better patient participation and increased cost effectiveness. PRM physicians have to identify patients at risk of continuing activity limitation and participation restriction who will benefit from an early rehabilitation process and formulate a PRM programme of care taking into account each patient's environmental factors.

One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of PRM interventions. Soft tissue musculoskeletal disorders (MSDs) and injuries are associated with significant pain and loss of function that may lead to significant disability. The aim of this paper is to define the role of PRM physician in the management of local soft tissue MSDs and injuries with their specific focus on assessing and improving function as well as participation in the community. The training of PRM specialists make them well equipped to successfully treat MSDs including soft tissue MSDs and injuries. PRM specialists may well meet the needs of patients with soft tissue MSDs and injuries using PRM approaches including 1) assessment based on the comprehensive model of functioning, the International Classification of Functioning, Disability and Health (ICF), that enable them to identify the areas of impaired functioning in order to apply necessary measures; 2) accurate diagnosis using instrumental diagnostic procedures in addition to clinical examination; 3) outcome measurements available to them; 4) evidence-based pharmacological and nonpharmacological treatments; and finally 5) maintenance of social involvement including "return to work" based on restoration of function, all of which will eventually result in improved quality of life for patients with soft tissue MSDs and injuries.

Background: Obesity is related to the development of functional and mobility impairment, musculoskeletal pain and orthopedic problems. Irrespective of age, obese children and adults have impaired walking capacity and body transfer ability, and difficulties navigating obstacle courses or community spaces. Obesity is related to relative strength deficits, musculoskeletal pain, kinesiophobia, low self-efficacy and a decline in quality of life., Aim: This review provides an update of the available evidence for the efficacy of outpatient rehabilitation programs for the treatment of disabling obesity., Results: Outpatient rehabilitation programs can effectively improve muscle strength, self-confidence and physical function. Key rehabilitation components should include aerobic exercise (AX), resistance exercise (RX) and cognitive strategies to cope with the unique challenges posed by obesity. Available high quality evidence indicates that 3-18 month rehabilitation programs that included aerobic and strengthening exercise (2-3 days per week) with caloric restriction (typically 500-750 kcal deficit/ day), elicited the best changes in functional performance measures compared with exercise or diet alone., Conclusion: Comprehensive outpatient rehabilitation interventions coupled with diet can catalyze lifestyle patterns that improve and preserve physical function over the life span.

Background: While patients' satisfaction with rehabilitation care is often measured, the knowledge of their experiences during delivery of care and of which characteristics may lead them to experience problems remains largely undocumented., Aim: To assess the quality of patients' experiences receiving post-acute care for musculoskeletal disorders in outpatient rehabilitation settings. To describe the extent to which variations in reported quality of patients' experiences were related to their characteristics., Design: A cross sectional, self-reported survey., Setting: 3 outpatient rehabilitation units., Population: Four hundred sixty-five outpatients. Mean age 39.4 (SD=11.9)., Methods: A problem score (from 0 to 100%) of self-reported experiences was calculated on 7 specific aspects of care (belonging to organizational environment and professionals' attitudes and behaviors) and compared among participants' subgroups., Results: Mean scores of the organizational environment area showed higher amount of problems (43.3%) than the professionals' attitudes and behaviours area (34.7%). Two multivariate linear regression models (with adjusted R(2) 9.3% and 4.9%) indicated that older patients and those with high global rating change were less likely to experience problems in the two areas., Conclusion: Problems on aspects of care were commonly experienced by patients with musculoskeletal disorders in outpatient rehabilitation settings. The age and health of patients were associated to these problems, but explained only a small variation in them., Clinical Rehabilitation Impact: Surveys measuring patients' experiences can be used to monitor the actual performance of rehabilitation settings and to pinpoint the exact issues needing to be addressed to improve quality as well as to make comparison among centres.

Aim: In order to present to our readers the best available evidence in the field of Rehabilitation, we continuously perform systematic reviews of the articles regularly published in the Cochrane Library, being these considered the most reliable instruments of synthesis, reliable because based on a strict methodology. Moreover, according to the aim of the Cochrane Collaboration, in order to diffuse sound data, we invited Cochrane authors to republish their articles in the EJPRM. The aim of the present paper is to systematically review all the new rehabilitation papers published from December 2011 up to February 2012 from the Cochrane Library in order to provide to physicians involved in the field a summary of the best evidence nowadays available., Methods: The authors systematically searched all the new papers of rehabilitative interest from the 5th of December 2011 to the 27th of February 2012 in the Cochrane Library. The retrieved papers have been then divided in subgroups on the base of the topic and the Cochrane Groups., Results: The number of included papers was 5, 4 new reviews and 2 updates reviews. A synthesis of abstracts is presented., Conclusion: The field of rehabilitation, being cross-sectional to the whole Medicine, can be of interest for many specialty. This was documented by the large number of Cochrane Group publishing reviews of Rehabilitative interest. Reviewing periodically the Cochrane reviews is a good way to remain up to date and to find solid bases for everyday clinical practice.

Aim: Evidence in medicine depends on original studies but also comes from systematic review. The most the literature grows up, the most systematic reviews are needed to synthesize the evidence, since this can help operators in decision making. The Cochrane reviews are considered the most reliable instruments of synthesis, being based on a strict methodology. Since 2007 the EJPRM offer the service of listing and presenting all these reviews systematically. The aim of the present paper was to methodically review all the new rehabilitation papers published from July 2011 up to December 2011 from the Cochrane Library in order to provide to physicians involved in the field a summary of the best evidence nowadays available., Methods: The authors thoroughly searched all the new papers of rehabilitative interest from the July 14 to December 4, 2011 in the Cochrane Library. The retrieved papers have been consequently divided in subgroups on the base of the topic and the Cochrane Groups., Results: The number of included papers was seven, five were new reviews and two were updates. A synthesis of their abstracts is presented., Conclusion: The field of rehabilitation, being cross-sectional to the whole medicine, can be of interest for many specialty. This was documented by the large number of Cochrane Group publishing reviews of rehabilitative interest. Reviewing periodically the Cochrane reviews is a good way to remain up to date and to find solid bases for everyday clinical practice.

Aim: Since 2007 we focused our attention as EJPRM to the best available clinical evidence as offered by the Cochrane Collaboration. Due to the absence of a specific Rehabilitation Group.only a Field exists), reviews of PRM interest are in different groups and not easy to find. Consequently, the EJPRM offer the service of listing and presenting all these reviews systematically. The aim of the present paper is to systematically review all the new rehabilitation papers published from February 2011 up to April 2011 from the Cochrane Library in order to provide to physicians involved in the field a summary of the best evidence nowadays available., Methods: The authors systematically searched all the new papers of rehabilitative interest in the 2nd of February 2011 to the 22nd of April 2011 in the Cochrane Library. The retrieved papers have been then divided in subgroups on the base of the topic and the Cochrane Groups., Results: The number of included papers was 5, 3 new reviews and 2 updates reviews. Three reviews deals with neurological rehabilitation, 2 with musculoskeletal disorders and one with orthoses., Conclusion: The Cochrane Collaboration and his product, the Cochrane Library, are really relevant instruments to improve EBM in medical practice and thus also in the Rehabilitation Field. The present paper can help Rehabilitation Specialists to easily retrieve the conclusions of the most relevant and updated reviews in order to change their clinical practice in a more rapid and effective way.

Aim: Since 2007 we focused our attention as EJPRM to the best available clinical evidence as offered by the Cochrane Collaboration. Due to the absence of a specific Rehabilitation Group (only a Field exists), reviews of PRM interest are in different groups and not easy to find. Consequently, the EJPRM offer the service of listing and presenting all these reviews systematically. The aim of the present paper was to systematically review all the new rehabilitation papers published during 2010 fourth quarter up to the beginning of 2011 from the Cochrane Library in order to provide to physicians involved in the field a summary of the best evidence nowadays available., Methods: The authors systematically searched all the new papers of rehabilitative interest in the 1st of September 2010 to the 1st of February 2011 in the Cochrane Library. The retrieved papers have been then divided in subgroups on the base of the topic and the Cochrane Groups., Results: The number of included papers was 3, all of these were new reviews. One new reviews deals with neurological rehabilitation , one with musculoskeletal disorders and one with orthoses. No updated reviews were retrieved., Conclusion: The Cochrane Collaboration and his product, the Cochrane Library, are really relevant instruments to improve EBM in medical practice and thus also in the Rehabilitation Field. The present paper can help Rehabilitation Specialists to easily retrieve the conclusions of the most relevant and updated reviews in order to change their clinical practice in a more rapid and effective way.

Aim: Since 2007 we have focused our attention to the best available clinical evidence offered by the Cochrane Collaboration. Due to the absence of a specific Rehabilitation Group (only a Field exists), reviews of PRM interest are in different groups and not easy to find. Consequently, the EJPRM lists and presents all these reviews systematically. The aim of the present paper was to systematically review all the new rehabilitation papers published in the 8th, 9th and 10th issues of 2010 from the Cochrane Library in order to provide to physicians involved in the field a summary of the best evidence nowadays available., Methods: The author systematically searched all the new papers of rehabilitative interest in the 8th, 9th and 10th Issues of 2010 of the Cochrane Library. The retrieved papers have been then divided in subgroups on the base of the topic and the Cochrane Groups., Results: The number of included papers was four, all of these were new reviews. Two new reviews deal with neurological rehabilitation , one with musculoskeletal disorders and one with pain. No updated reviews were retrieved., Conclusion: The Cochrane Collaboration and the Cochrane Library are really relevant instruments to improve EBM in medical practice and thus also in the Rehabilitation Field. The present paper can help Rehabilitation Specialists to easily retrieve the conclusions of the most relevant and updated reviews in order to change their clinical practice in a more rapid and effective way.

Aim: Since 2007 we focused our attention as EJPRM to the best available clinical evidence as offered by the Cochrane Collaboration. Due to the absence of a specific Rehabilitation Group (only a Field exists), reviews of PRM interest are in different groups and not easy to find. Consequently, the EJPRM offer the service of listing and presenting all these reviews systematically. The aim of the present paper was to systematically review all the new rehabilitation papers published in the 3rd 4th and 5th Issues of 2010 from the Cochrane Library in order to provide to physicians involved in the field a summary of the best evidence nowadays available., Methods: The author systematically searched all the new papers of rehabilitative interest in the 3rd 4th and 5th Issues of 2010 of the Cochrane Library. The retrieved papers have been then divided in subgroups on the base of the topic and the Cochrane Groups., Results: The number of included papers was 8, 7 of these were new reviews. Four new reviews deal with neurological rehabilitation, being performed by the Stroke group, 2 with musculoskeletal disorders, 1 with cardiac rehabilitation. Moreover, 1 review from the Back Group the has been updated., Conclusion: The Cochrane Collaboration and his product, the Cochrane Library, are really relevant instruments to improve EBM in medical practice and thus also in the Rehabilitation Field. The present paper can help Rehabilitation Specialists to easily retrieve the conclusions of the most relevant and updated reviews in order to change their clinical practice in a more rapid and effective way.

Background: Since 2007 we focused our attention as EJPRM to the best available clinical evidence offered by the Cochrane Collaboration. Due to the absence of a specific Rehabilitation Group (only a field exists), reviews of PRM interest are in different groups and not easy to find. Consequently, the EJPRM lists and presents all these reviews systematically., Aim: The aim of the present paper is to systematically review all the new rehabilitation papers published in the Cochrane Library 4th Issue 2009 in order to provide to physicians involved in the field a summary of the best evidence nowadays available., Methods: The author systematically searched all the new papers of rehabilitative interest in the Cochrane Library 4th Issue 2009. The retrieved papers have been divided in subgroups on the base of the topic and the Cochrane Groups., Results: The number of included papers was 19: 11 were new reviews. Three new reviews deal with neurological rehabilitation, 6 with musculoskeletal disorders, 3 with pain management. Moreover, 8 reviews have been updated: 4 related to musculoskeletal disorders, 2 to neurological disorders, and 1 to respiratory rehabilitation. All these are listed at the end of the paper., Conclusion: The Cochrane Collaboration and its product, the Cochrane Library, are really relevant instruments to improve EBM in medical practice and thus also in the Rehabilitation Field. The present paper can help Rehabilitation Specialists to easily retrieve the conclusions of the most relevant and updated reviews in order to change their clinical practice in a more rapid and effective way.

Aim: The International Classification of Functioning, Disability and Health (ICF) provides a useful framework for the comprehensive description of the patients' functional health. The aim of this study was to identify the ICF categories that represent the patients' problems treated by manual medicine practitioners in order to facilitate its application in manual medicine. This selection of ICF categories could be used for assessment, treatment documentation and quality management in manual medicine practice., Methods: Swiss manual medicine experts were asked about the patients' problems commonly treated by manual medicine practitioners in a three-round survey using the Delphi technique. Responses were linked to the ICF., Results: Forty-eight manual medicine experts gave a total of 808 responses that were linked to 225 different ICF categories; 106 ICF categories which reached an agreement of at least 50% among the participants in the final Delphi-round were included in the set of ICF Intervention Categories for Manual Medicine; 42 (40%) of the categories are assigned to the ICF component body functions, 36 (34%) represent the ICF component body structures and 28 (26%) the ICF component activities and participation., Conclusion: A first proposal of ICF Intervention Categories for Manual Medicine was defined and needs to be validated in further studies.

Knowledge of the determinants of disability in musculoskeletal conditions (MSC) is critical for reducing their burden. No epidemiologic studies from a truly comprehensive perspective consider environmental factors (EF) and personal factors (PF) as determinants of disability. However, one can identify candidate EF from the International Classification of Functioning, Disability and Health (ICF) Core Sets for rheumatoid arthritis (RA), osteoporosis (OP), osteoarthritis (OA), low back pain (LBP) and chronic wide spread pain (CWP). The objective of this literature review was to contribute to the validation of the EF from the ICF Core Sets for MSC and the candidate PF from a (ICF) Delphi exercise, as well as from the report of the Bone and Joint Decade (BJD) Health Strategy Project. The results of the literature search focus on reviews published between January 1991 and March 2006 that contained information on EF and PF that determine disability in LBP, RA and OA. Many PF and EF included in the ICF Core Sets were confirmed as potential determinants of disability. However, regarding some contextual factors, in particular EF referring to the physical environment, there is a lack of reviews and clinical studies that have investigated their relevance to disability. The predominant medical model in studies on disability in MSC may explain this lack of evidence. However, the increasing attention given to the integrative model of functioning, disability and health of the World Health Organization (WHO) and the approval of the ICF by the World Health Assembly in 2001 may stimulate future research on the effect of EF and PF on disability.