Independence in activities after injury in humanitarian settings: assessment, change over time and associated factors

Injury represents a significant burden in humanitarian settings, overwhelming the limited trauma care resources. Trauma care in these settings mainly focuses on saving lives and limbs, and not on recovery in daily activities.

This thesis aimed at assessing recovery over the first six months after an acute orthopedic, visceral, and/or skin injury in different humanitarian settings, first revising and evaluating a measure of independence in activities, the Activity Independence Measure–Trauma (AIM-T). The research was conducted in eight health facilities supported or run by Médecins Sans Frontières in humanitarian settings, located in Burundi, Central African Republic, Cameroon, Iraq, Haiti, and Yemen.

The AIM-T was considered adequate to assess independence in activities after acute injury in humanitarian settings, and its validity and reliability were supported. The AIM-T has thus potential for use as an indicator of recovery in humanitarian settings. Regarding recovery, most patients still experience difficulties at six months. The association of early physiotherapy with better recovery of independence suggests that physiotherapy may be beneficial and may potentially be a modifiable factor to enhance recovery in humanitarian settings.