South asian contributions to the international rehabilitation literature: an online literature survey of 10 years

Pakistan Journal of Neurological Sciences (PJNS), Nov 2017

Physical medicine and rehabilitation (PM & R) deals with management, rehabilitation and community reintegration persons with disabilities. It is an emerging medical specialty in the South-Asian region (Pakistan, India, Bangladesh, Nepal, Srilanka ,Afghanistan, Bhutan and Maldives,). The region comprises 24% of the world population with a huge burden of disability. The contributions of South Asian authors to the international rehabilitation medicine literature are unknown. The aim of this study was to document the contributions of south Asian authors in the international rehabilitation literature in the last decade.

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South asian contributions to the international rehabilitation literature: an online literature survey of 10 years

V O L . South asian contributions to the international rehabilitation literature: an online literature sur vey of 10 years Sermad Ahmad Mangat 0 CMH Lahore Medical 0 Dental College 0 Lahore 0 Pakistan 0 Farooq Azam Rathore 0 Shahbaz Ali Nasir 0 CMH Lahore Medical 0 Dental College 0 Lahore 0 Pakistan 0 Mubasshar Shahid 0 CMH Lahore Medical 0 Dental College 0 Lahore 0 Pakistan 0 CMH Lahore Medical 0 Dental College 0 Lahore 0 Pakistan 0 0 Bahria University Medical and Dental College, Bahria University , Karachi , Pakistan Follow this and additional works at: http://ecommons.aku.edu/pjns Part of the Neurology Commons Recommended Citation - SOUTH ASIAN CONTRIBUTIONS TO THE INTERNATIONAL REHABILITATION LITERATURE: AN ONLINE LITERATURE SURVEY OF 10 YEARS 1CMH Lahore Medical and Dental College, Lahore, Pakistan 2Department of Rehabilitation Medicine, PNS Shifa Hospital, Karachi, Pakistan 3Department of Rehabilitation Medicine, Bahria University Medical and Dental College, Bahria University, Karachi, Pakistan Corresponding Author: Dr.Farooq A Rathore, Consultant,Department of Rehabilitation Medicine, PNS Shifa Hospital, DHA-II Karachi Date of submission: April 1 7, 2016 Date of revision: June 10, 2016 Date of acceptance: July 1, 2016 INTRODUCTION Physical medicine and rehabilitation (PM & R) deals with management, rehabilitation and community reintegration persons with disabilities. It is an emerging medical specialty in the South-Asian region (Pakistan, India, Bangladesh, Nepal, Srilanka ,Afghanistan, Bhutan and Maldives,). The region comprises 24% of the world population with a huge burden of disability. The contributions of South Asian authors to the international rehabilitation medicine literature are unknown. The aim of this study was to document the contributions of south Asian authors in the international rehabilitation literature in the last decade. METHODS Five leading international journals of PM &R were selected for the survey including American Journal of PM&R, Archives of PM&R, PM&R and Journal of Rehabilitation Medicine, Journal of Neurorehabilitation and Neural Repair The online archives of these journals (Jan 2005- Dec 2015) were reviewed. Total number of manuscripts published in a single issue was noted. Author’s affiliations were checked and manuscripts with at least one south Asian author were recorded. The article type, number of authors and author’s country were noted. Similar data was also obtained for Turkey and Iran. RESULTS The total number of manuscripts published in these five major PM&R journals in the last decade is 8341. South Asian authors published only 18 manuscripts. Thirteen were from India and five articles were from Pakistan. There was no contribution from any other South Asian country. In case of Pakistan, the same person was the lead and corresponding authors in all manuscripts. Fifteen articles had all South Asian authors while three articles had a foreign co-author too. The manuscripts were mostly related to Neuro-rehabilitation, Spinal cord injury & Pediatric followed by musculoskeletal, orthopedic and disaster rehabilitation. Most of the manuscripts were original research articles. CONCLUSIONS The contribution of South Asian authors to the leading international rehabilitation journals in the last one decade is less than 1 % although the burden of disability in this area is huge. There is a need to conduct more research on different aspects of disability and PM&R interventions and collaborate with colleagues abroad to improve the publication rate from this region of the world. South Asia, Research; Rehabilitation medicine, Physiatry; Pakistan INTRODUCTION Physical medicine and rehabilitation (PM&R) also referred to as physiatry or rehabilitation medicine is a branch of medicine concerned with “evaluation and treatment of, and coordination of care for, persons with musculoskeletal injuries, pain syndromes, and/or other physical or cognitive impairments or disabilities”.1 The primary focus is on maximal restoration of physical and psychological function, and on alleviation of pain The South-Asian region consists of Pakistan, India, Bangladesh, Nepal and Srilanka. This is one of the most densely populated areas of the world with an P A K I S T A N J O U R N A L O F N E U R O L O G I C A L S C I E N C E S During the same time, authors from Turkey and Iran published 242 and 21 manuscripts in these top five journals. DISCUSSION The research culture in South Asia is still evolving and has received low priority overall. The number of researchers as well as the research funding combined expenditure on research and development as a percent of gross domestic product (GDP) in the South Asian countries is low as compared to the developed countries.8 Majumder et al conducted a geographical analysis of biomedical publications from the South Asian countries over 25 years (1985-2009) using the PubMed database. They documented that only 1.1% of the articles indexed in PubMed in this period were published from South Asian countries.9 We have observed a similar pattern for publications from South Asian authors in the leading Rehabilitation medicine journals in a ten-year period (2005-2010). There can be many possible explanations for this low rate of publications. Rehabilitation medicine is advancing at a rapid pace in the High income countries while it is under developed in South Asian countries. These high-ranking Rehabilitation journals would prefer to publish new and interesting advances in PM&R instead of repetition of old, techniques and facts already known. There have been an increase in the number of randomized control trials being conducted and published in Rehabilitation Medicine in the last two decades. Unfortunately, high quality rigorously planned RCT in rehabilitation medicine are not being conducted in South Asian countries. Descriptive studies have a lower chance of acceptance as compared to a well-designed RCT. Another limiting factor could be the open access fee structure of some leading PM&R journals. The publishing cost of 60-200 Euros/page10 is prohibitive for an author working in South Asia as most of them lack any institutional support to cover the cost of publications. Other factor could include the problems being faced by researchers based in low-income countries who do not have English as their first language.11,12 Additional factors are availability of a limited number of trained physiatrists in only three countries (Bangladesh, India and Pakistan) who can conduct research related to rehabilitation medicine and publish it in international PM&R journals. Most of the manuscripts published from South Asia during this ten-year period were from India. This is consistent with similar findings, which report that India has the best research output from this region. There is a need for better cooperation and collaboration among researchers and physiatrists from different South Asian countries in order to increase the scientific output. This trend also reveals the high research output of Turkey and Iran in the field of PM&R which is substantially better than the combined output of South Asian countries. There are some limitations of the study. We only selected top five PM&R journals. There is a possibility that South Asian authors have published manuscript in other international PM&R journals in the same period, which we could not document. We did not contact the corresponding authors of these manuscripts to get an insight regarding their motivation and struggle to publish in these high-ranking international PM&R journals. In addition, we could not conclusively decide only based on the authors information provided if the lead author was a physiatrist or not. RECOMMENDATIONS We recommend the following to improve the research output in PM&R and disability from South Asia. • There is a need to establish PM&R research groups in different South Asian countries, which should collaborate and coordinate between the different countries. These groups, should conduct research on different PM&R topics by contributing data and promoting exchange visits. • Registries on different disabilities like Stroke, spinal cord injuries, pediatric disabilities and rheumatologic should be established in the South Asian countries. It will facilitate estimating the actual burden of these disabilities and documenting data. • South Asian physiatrists should coordinate and collaborate with the international PM&R societies P A K I S T A N J O U R N A L O F N E U R O L O G I C A L S C I E N C E S • • like International society of PM&R, European Society of PM&R, Asia-Ocenian society of PM&R in order to establish mentoring program between the physiatrists based in South Asia and abroad in order to improve the research output. A national body of physiatrists should be created, governed by leading local Physiatrists providing healthcare as well as collaborating with international physiatrists. Training courses should be offered to those willing to improve their research skills which will genuinely improve the output. CONCLUSIONS The contribution of South Asian authors and physiatrists in the international rehabilitation journals over a period of 10 years is less than 1 % although the burden of disability in this area is huge. There is a need to conduct more research on different aspects of disability and PM&R interventions and collaborate with colleagues abroad to improve the publication rate from this region of the world. 1 5 1. Physical Medicine and Rehabilitation. Definition. Available from https://www.nlm.nih.gov/tsd/acquisitions/cdm/subj ects81. html Accessed on 31st August 2016 2. United states Census Bureau. US and world population clock . Available from https://www.census.gov/popclock/ Accessed on 31st August 2016 . 3. American Journal of Physical Medicine and Rehabilitation . Available from http://journals.lww.com/ajpmr/Pages/default.aspx Accessed 18th August 2016 . 4. Archives of Physical medicine and Rehabilitation . Available from http://www.archives-pmr. org/ Accessed 18th August 2016 . 5. European Journal of Physical Medicine and Rehabilitation . Available from http://www.minervamedica.it/en/journals/europamedicophysica/index.phpAccessed 18th August 2016 . 6. Journal of Neurorehabilitation and Neural Repair . Available from http://nnr.sagepub. com/Accessed 18th August 2016 . 7. Journal of Rehabilitation Medicine. Available from http://www.medicaljournals. se/jrm/Accessed 18th August 2016 . 8. United Nations Educational , Scientific and Cultural Organization Institute for Statistics. Data centre: summary data: profiles [Internet] . Available from: http://stats.uis.unesco.org/unesco/TableViewer/do cument.aspx?ReportId=143& IF _Language=eng 9. Azim Majumder MA , Shaban SF , Rahman S , Rahman N , Ahmed M , Bin Abdulrahman KA , et al. PubMed-based quantitative analysis of biomedical publications in the SAARC countries: 1985-2009 . J Coll Physicians Surg Pak . 2012 ; 22 : 560 - 4 . 10. Instructions to authors . Journal of Rehabilitation Medicine . Available from http://www.medicaljournals.se/jrm/index.php ?opti on=com_content&view=article&id=8&Itemid=1 1#pagecharge Accessed on 27th August 2016 11. Bilić-Zulle L , Frković V , Turk T , Azman J , Petrovecki M. Prevalence of plagiarism among medical students . Croatian Med J. 2005 ; 46 ( 1 ): 126 . 12. Roig M. Plagiarism and self-plagiarism: What every author should know . Biochemia Medica . 2010 ; 20 ( 3 ): 295 - 300 .


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Sermad Ahmad Mangat, Farooq Azam Rathore, Shahbaz Ali Nasir, Mubasshar Shahid, Hassaan Altaf. South asian contributions to the international rehabilitation literature: an online literature survey of 10 years, Pakistan Journal of Neurological Sciences (PJNS), 2016,