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Objective To systematically map the current evidence about the characteristics of health systems, providers and patients to design rehabilitation care for post coronavirus disease 2019 (COVID-19) condition. Methods We conducted a scoping review by searching the databases: MEDLINE[R], Embase[R], Web of Science, Cochrane COVID-19 Registry and Cochrane Central Register of Controlled Trials, from inception to 22 April 2022. The search strategy included terms related to (i) post COVID-19 condition and other currently known terminologies; (ii) care models and pathways; and (iii) rehabilitation. We applied no language or study design restrictions. Two pairs of researchers independently screened title, abstracts and full-text articles and extracted data. We charted the evidence according to five topics: (i) care model components and functions; (ii) safe delivery of rehabilitation; (iii) referral principles; (iv) service delivery settings; and (v) health-care professionals. Findings We screened 13 753 titles and abstracts, read 154 full-text articles, and included 37 articles. The current evidence is conceptual and expert based. Care model components included multidisciplinary teams, continuity or coordination of care, people-centred care and shared decision-making between clinicians and patients. Care model functions included standardized symptoms assessment, telehealth and virtual care and follow-up system. Rehabilitation services were integrated at all levels of a health system from primary care to tertiary hospital-based care. Health-care workers delivering services within a multidisciplinary team included mostly physiotherapists, occupational therapists and psychologists. Conclusion Key policy messages include implementing a multilevel and multiprofessional model; leveraging country health systems' strengths and learning from other conditions; financing rehabilitation research providing standardized outcomes; and guidance to increase patient safety. Objectif Recenser systematiquement les donnees probantes actuelles concernant les caracteristiques des systemes de sante, prestataires et patients afin de definir un modele de readaptation pour les affections consecutives a la maladie a coronavirus 2019 (COVID-19). Methodes Nous avons mene une analyse exploratoire en etudiant plusieurs bases de donnees: MEDLINE[R], Embase[R], Web of Science, Registre Cochrane des etudes sur la COVID-19 et Registre central Cochrane des essais controles, depuis le debut et jusqu'au 22 avril 2022. La strategie de recherche consistait a inclure des termes en lien avec (i) les affections post-COVID-19 et d'autres terminologies connues a ce jour; (ii) les modeles et parcours de soins; et enfin, (iii) la readaptation. Nous n'avons applique aucune restriction de langue ou de format d'etude. Deux binomes de chercheurs ont passe au crible les titres, resumes et articles complets, independamment l'un de l'autre, pour ensuite en extraire des informations. Nous avons etabli une grille de donnees probantes autour de cinq themes: (i) elements et fonctions des modeles de soins; (ii) fourniture de services de readaptation surs; (iii) principes de reference; (iv) lieux de prestation des services; et enfin, (v) professionnels de la sante. Resultats Nous avons examine 13 753 titres et resumes, lu 154 articles complets et inclus 37 d'entre eux. Les donnees probantes actuelles reposent sur des concepts et expertises. Les elements des modeles de soins impliquent des equipes multidisciplinaires, une continuite ou une coordination des soins, des prestations axees sur l'humain et une prise de decision partagee entre medecins et patients. Parmi les fonctions des modeles de soins figurent l'evaluation standardisee des symptomes, la telemedecine et les soins virtuels, ainsi que le mecanisme de suivi. Les services de readaptation sont presents a tous les niveaux du systeme de sante, des soins primaires aux soins tertiaires en milieu hospitalier. Les equipes multidisciplinaires en charge de la readaptation sont principalement composees de kinesitherapeutes, d'ergotherapeutes et de psychologues. Conclusion Cette demarche vehicule d'importants messages politiques: la mise en oeuvre d'un modele comprenant plusieurs niveaux et professions; une valorisation des atouts du systeme sanitaire en vigueur dans le pays, ainsi qu'une pratique qui s'inspire d'autres affections; le financement de recherches sur la readaptation afin de parvenir a des resultats standardises; et enfin, des conseils pour ameliorer la securite des patients. Objetivo Esbozar de manera sistematica la evidencia actual sobre las caracteristicas de los sistemas sanitarios, los proveedores y los pacientes con el fin de disenar la atencion de rehabilitacion para la afeccion posterior a la enfermedad por coronavirus de 2019 (COVID-19). Metodos Se realizo una revision exploratoria mediante busquedas en las bases de datos: MEDLINE[R], Embase[R], Web of Science, Registro Cochrane COVID-19 y Registro Cochrane Central de Ensayos Controlados, desde su inicio hasta el 22 de abril de 2022. La estrategia de busqueda incluyo terminos relacionados con (i) afeccion posterior a la COVID-19 y otras terminologias que se conocen en la actualidad; (ii) modelos y vias de atencion; y (iii) rehabilitacion. No se aplico ninguna restriccion de idioma o de diseno del estudio. Dos pares de investigadores revisaron de forma independiente el titulo, los resumenes y los articulos de texto completo y extrajeron los datos. Se clasifico la evidencia de acuerdo con cinco temas: (i) componentes y funciones del modelo de atencion; (ii) prestacion segura de la rehabilitacion; (iii) principios de derivacion; (iv) entornos de prestacion de servicios; y (v) profesionales sanitarios. Resultados Se revisaron 13 753 titulos y resumenes, se leyeron 154 articulos de texto completo y se incluyeron 37 articulos. La evidencia actual es conceptual y de especialistas. Los componentes de los modelos de atencion incluyeron equipos multidisciplinarios, continuidad o coordinacion de la atencion, atencion orientada a las personas y toma de decisiones compartida entre los medicos y los pacientes. Las funciones del modelo de atencion incluyeron la evaluacion estandarizada de los sintomas, la telemedicina y el sistema de atencion y seguimiento virtual. Los servicios de rehabilitacion se integraron en todos los niveles de un sistema sanitario, desde la atencion primaria hasta la atencion hospitalaria terciaria. El personal sanitario que prestaba servicios dentro de un equipo multidisciplinar incluia en su mayoria fisioterapeutas, terapeutas ocupacionales y psicologos. Conclusion Los mensajes de politicas mas importantes incluyen la aplicacion de un modelo multinivel y multiprofesional; el aprovechamiento de las fortalezas del sistema sanitario del pais y el aprendizaje de otras afecciones; la financiacion de la investigacion en materia de rehabilitacion que proporcione resultados estandarizados; y la orientacion para aumentar la seguridad de los pacientes., Introduction People living with post coronavirus disease 2019 (COVID-19) condition, first described as long COVID, need recognition and rehabilitation. (1) The World Health Organization (WHO) has created a definition for [...]

This article discusses the importance of health policy and systems research (HPSR) in improving rehabilitation services in health systems. It highlights the global need for rehabilitation services and the high unmet need, particularly in low- and middle-income countries. The article argues that HPSR can provide the evidence needed to prioritize rehabilitation, evaluate outcomes, and strengthen health systems. It also mentions the establishment of the World Rehabilitation Alliance (WRA) and its research workstream, which aims to advocate for the use of HPSR evidence for rehabilitation. The authors express their support for the WRA's mission and commit to promoting HPSR for rehabilitation in their respective academic journals. The document provides a list of authors and publications related to rehabilitation, as well as information about funding, conflicts of interest, and the publisher's note. It references various articles and reports on rehabilitation, including the definition of rehabilitation, global estimates of the need for rehabilitation, and the global report on health equity for persons with disabilities. It also mentions the United Nations' Sustainable Development Goals and the World Health Organization's efforts to prioritize rehabilitation in health systems. The document concludes with information about the World Rehabilitation Alliance and the Rehabilitation 2030 initiative. [Extracted from the article]

The coronavirus disease 2019 (COVID-19) pandemic substantially impacted different age groups, with children and young people not exempted. Many have experienced enduring health consequences. Presently, there is no consensus on the health outcomes to assess in children and young people with post-COVID-19 condition. Furthermore, it is unclear which measurement instruments are appropriate for use in research and clinical management of children and young people with post-COVID-19. To address these unmet needs, we conducted a consensus study, aiming to develop a core outcome set (COS) and an associated core outcome measurement set (COMS) for evaluating post-COVID-19 condition in children and young people. Our methodology comprised of two phases. In phase 1 (to create a COS), we performed an extensive literature review and categorisation of outcomes, and prioritised those outcomes in a two-round online modified Delphi process followed by a consensus meeting. In phase 2 (to create the COMS), we performed another modified Delphi consensus process to evaluate measurement instruments for previously defined core outcomes from phase 1, followed by an online consensus workshop to finalise recommendations regarding the most appropriate instruments for each core outcome. In phase 1, 214 participants from 37 countries participated, with 154 (72%) contributing to both Delphi rounds. The subsequent online consensus meeting resulted in a final COS which encompassed seven critical outcomes: fatigue; post-exertion symptoms; work/occupational and study changes; as well as functional changes, symptoms, and conditions relating to cardiovascular, neuro-cognitive, gastrointestinal and physical outcomes. In phase 2, 11 international experts were involved in a modified Delphi process, selecting measurement instruments for a subsequent online consensus workshop where 30 voting participants discussed and independently scored the selected instruments. As a result of this consensus process, four instruments met a priori consensus criteria for inclusion: PedsQL multidimensional fatigue scale for "fatigue"; PedsQL gastrointestinal symptom scales for "gastrointestinal"; PedsQL cognitive functioning scale for "neurocognitive" and EQ-5D for "physical functioning". Despite proposing outcome measurement instruments for the remaining three core outcomes ("cardiovascular", "post-exertional malaise", "work/occupational and study changes"), a consensus was not achieved. Our international, consensus-based initiative presents a robust framework for evaluating post-COVID-19 condition in children and young people in research and clinical practice via a rigorously defined COS and associated COMS. It will aid in the uniform measurement and reporting of relevant health outcomes worldwide., Competing Interests: Conflict of interest: D. Munblit is a Co-Chair of International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Global Paediatric Long COVID Working Group, member of ISARIC working group on long-term follow-up in adults. C. Apfelbacher reports grants or contracts from Dr Wolff Group, Bionorica and The European Cooperation in Science and Technology (COST); he also acknowledges consulting fees from the Dr Wolff Group, Bionorica, Sanofi and LEO Pharma; he serves as a Co-Chair Harmonising Outcome Measures for Eczema (HOME) initiative and is Co-Chair of the Hand Eczema Core Outcome Set (HECOS) initiative and is core principal investigator of the KUNOKids Health Study (Regensburg, Germany). J.V. Diaz is the lead of the clinical management response pillar for COVID-19 and in that capacity convenes the WHO Clinical Characterization and Management Research working group; the Post COVID-19 COS steering committee was a sub-working group of this bigger group. O.L. Aiyegbusi has received research grants from UCB, Kidney Research UK, Gilead Sciences Ltd, The Health Foundation, NIHR Birmingham BRC, NIHR ARC, NIHR BTRU, Innovate UK, Merck, GSK, Anthony Nolan and Sarcoma UK; he has also received personal fees from GSK, Gilead Sciences, Innovate UK and Merck. C.R. Oliveira receives grant support from the National Institutes of Health (NIH), grant numbers OT2HL161847 and K23AI159518. P.R. Williamson is chair of the Core Outcome Measures in Effectiveness Trials (COMET) Management Group. Other authors declare that they have no competing interests., (Copyright ©The authors 2024.)

Research on health policy, systems, and services (HPSSR) has seen significant growth in recent decades and received increasing attention in the field of rehabilitation. This growth is driven by the imperative to effectively address real-life challenges in complex healthcare settings. A recent resolution on 'Strengthening rehabilitation in health systems' adopted by the World Health Assembly emphasizes the need to support societal health goals related to rehabilitation, particularly to promote high-quality rehabilitation research, including HPSSR. This conceptual paper, discussed with the participants in the 5 th Cochrane Rehabilitation Methodological Meeting held in Milan on September 2023, outlines study designs at diverse levels at which HPSSR studies can be conducted: the macro, meso, and micro levels. It categorizes research questions into four types: those framed from the perspective of policies, healthcare delivery organizations or systems, defined patient or provider populations, and important data sources or research methods. Illustrative examples of appropriate methodologies are provided for each type of research question, demonstrating the potential of HPSSR in shaping policies, improving healthcare delivery, and addressing patient and provider perspectives. The paper concludes by discussing the applicability, usefulness, and implementation of HPSSR findings, and the importance of knowledge translation strategies, drawing insights from implementation science. The goal is to facilitate the integration of research findings into everyday clinical practice to bridge the gap between research and practice in rehabilitation.

Cochrane Rehabilitation developed a series of actions to provide the global rehabilitation community with the best available evidence to respond to the COVID-19 pandemic. These initiatives constituted the REH-COVER (Rehabilitation COVID-19 evidence-based response) action. In March 2020, the first initiative started in agreement with the European Journal of Physical and Rehabilitation Medicine (EJPRM): the rapid systematic review of all papers relevant to COVID-19 rehabilitation to inform rehabilitation health professionals rapidly. Currently, we are facing the long-term consequences of COVID-19, initially called "long Covid" and now named post COVID-19 condition (PCC), which led to the request by the WHO Rehabilitation Programme for evidence synthesis to support the development of specific recommendations. Cochrane Rehabilitation provided the best available evidence from the REH-COVER rapid living systematic review results, a systematic scoping review on the models of care and a summary of "evidence relevant to" the rehabilitation for adults with PCC. Based on this evidence, expert groups developed the 16 recommendations for the rehabilitation of adults with PCC recently published in Chapter 24 of the WHO "Clinical management of COVID-19 living guideline." This paper aims to introduce the Special Section of EJPRM reporting the work performed by Cochrane Rehabilitation to produce a summary of the existing "evidence relevant to" the rehabilitation of adults with PCC. The paper reports the methodology (overview of systematic reviews with mapping) and introduces the concept of "evidence relevant to" rehabilitation.