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Evidence in Rehabilitation Medicine

Between Facts and Prejudices

Negrini, Stefano, MD

American Journal of Physical Medicine & Rehabilitation: February 2019 - Volume 98 - Issue 2 - p 88–96
doi: 10.1097/PHM.0000000000001033
The 2018 DeLisa Lecture

The relationship between evidence-based medicine and rehabilitation medicine is somewhat controversial. The motto “there is no evidence in rehabilitation medicine” is at times a real burden on the shoulders of rehabilitation medicine. There are many ideas around evidence in rehabilitation medicine; some are correct, whereas others are probably prejudices only. In this article, it is first discussed what evidence is, its origin and meaning, giving some notes about Cochrane—arguably, the criterion standard of evidence medicine. The relationship between rehabilitation medicine and evidence is then faced, to try to understand why these difficulties exist; it is considered what rehabilitation medicine is, comparing rehabilitation medicine with the other “classical” medical specialties; the problems with evidence generation and the actual state of research in rehabilitation medicine. The implementation of evidence in rehabilitation medicine is also introduced, including a brief discussion of knowledge translation, what it is, and why it is important, paying particular attention to Cochrane Rehabilitation—the new global rehabilitation medicine body that is facing these issues. Finally, some solutions for evidence in rehabilitation medicine are proposed.

From the Clinical and Experimental Sciences Department, University of Brescia, Brescia, Italy; and IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.

All correspondence should be addressed to: Stefano Negrini, MD, Fondazione Don Carlo Gnocchi, Piazzale Morandi 6, 20121 Milano, Italy.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.