Functioning and Disability
.jpg "Fatema Newaz, N/A, MD photo")
Fatema Newaz, N/A, MD
Assistant Professor
Kumudini Women's Medical College and Hospital
Dhaka, Dhaka, Bangladesh
Iffat Islam Khan, MD
BIHS General Hospital, Dhaka Bangladesh
Dhanmondi, Dhaka, Dhaka, Bangladesh
Taslim Uddin, MD
Professor
Bangladesh Medical University
Dhaka, Dhaka, Bangladesh
To identify disability patterns, assess prior treatments, design individualized management plans, establish tele-rehabilitation follow-up, and evaluate the preliminary effects of a pilot CBR intervention on function, participation, and caregiver satisfaction.
Design:
A pilot randomized controlled study was conducted during a CBR health camp at Kadba Talagram Tach Laha High School, Barura Municipality, Cumilla, on 21 May 2025, supported by the Rotary Club. The multidisciplinary team included a physiatrist, pediatrician, orthopaedic surgeon, internist, physiotherapist, occupational therapist, speech and language therapist, psychologist, nutritionist, rehabilitation nurse, and volunteers. Baseline data and follow-up outcomes at four weeks were collected using standardized instruments: the Gross Motor Function Classification System (GMFCS) for mobility, the Pediatric Evaluation of Disability Inventory (PEDI) for daily activity and participation, and the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) for overall functioning. Caregiver satisfaction was assessed using the Client Satisfaction Questionnaire-8 (CSQ-8) during the four-week follow-up.
Results:
Among 175 attendees, 35 individuals (aged 1.5–18 years) had physical disabilities, predominantly cerebral palsy (60%), neuromuscular disorders (25%), and post-traumatic sequelae (15%). Most participants had received irregular or no prior physiotherapy or rehabilitation services before attending the camp. Each was provided with an individualized, multidisciplinary management plan integrating physiotherapy, occupational therapy, speech therapy, and caregiver training. Following intervention and tele-rehabilitation guidance, mean GMFCS scores improved by one functional level in 28.6% of cases, PEDI functional skill scores increased by 22%, and WHODAS 2.0 scores decreased by 18% at four weeks. Caregiver satisfaction, assessed using the CSQ-8, reached 92%.
Conclusions:
The pilot demonstrates that CBR-based one-stop multidisciplinary service delivery and short-term tele-follow-up can measurably improve functional outcomes and satisfaction among children with disabilities in rural Bangladesh. This model offers a feasible, scalable framework for establishing sustainable community rehabilitation networks nationwide.
