Early physical and functional rehabilitation of trauma patients in the MSF trauma center in Kunduz, Afghanistan: Luxury or Necessity? Introduction Results and discussion Methods Conclusions References Descriptive cohort study Study population: trauma patients admitted for inpatient care between January and June 2015 Pain assessed through simplified functional pain scale (based on UCLA shoulder scale), range 0-5 Functional independence assessed through modified FIM score, composed of 2 subscores for upper and lower limb: Scores of 1-5 were modified from the FIM: Integration of physiotherapists within any trauma medical team should be a necessity Use of the adapted functional score was feasible for complex trauma patients with different types of injury in a humanitarian setting. Out of 1528 admitted patients: 92% received at least one physiotherapy session (n=1410) 1346 patients (88%) received physiotherapy in IPD and 819 (53%) in OPD. 62% received IPD sessions within two days of admission. Physiotherapy services are scarce and under-resourced in low- and middle-income countries (LMIC) For trauma particularly, which disproportionally affects LMIC, physiotherapy can critically enhance functional recovery Few tools exist for monitoring and evaluation of physiotherapy programmes in LMICS, and programme performance is rarely documented 1. Landry MD, O’Connell C, Tardif G, Burns A. Post-earthquake Haiti: the critical role for rehabilitation services following a humanitarian crisis. Disabil Rehabil 2010;32:1616–8. 2. WHO. Minimum Standards for Rehabilitation-Emergency Medical Teams. Geneva[under press], Reinhardt JD, Li J, Gosney J et al. Disability and health-related rehabilitation in international disaster relief. Glob Health Action 2011;4:7191. Objectives To describe the characteristics of trauma patients and the evolution of their functional recovery over the course of their in- and outpatient stay To describe the relevance of the adapted functional score in this setting Bérangère Gohy, Engy Ali, Rafael Van den Bergh, Erin Schillberg, Masood Nasim, Muhammad Mahmood Naimi, Sophia Cheréstal, Pauline Falipou, Eric Weerts, Peter Skelton, Catherine Van Overloop, Miguel Trelles Contact: MSF in collaboration with Handicap International integrated early rehabilitation services in Kunduz Trauma Center (KTC), and developed an adapted functional score for patient and programme monitoring 7 Complete independence 6 Modified independence – use of assisting device 5 Supervision 4 Minimal assistance (75% self-sufficient) 3 Moderate assistance (50-75% self-sufficient 2 Maximal assistance (25-49% self sufficient) 1 Total assistance – <25% self-sufficient 5 Independent 4 Independent – with difficulties 3 Requires use of a device 2 Subject performs task, requires physical help 1 Subject unable to perform task FIM score systemAdapted functional score system Risk factors for discontinuing physiotherapy after IPD discharge: -Being a severe case -Aged TBI or internal organ injury -Victim of violent trauma -High functional score at IPD exit Functional independence and pain management improved during stay: -Among patients with both IPD scores (n=535): at discharge 32% functionally independent and 28% no/occasional pain -Among patients with both OPD scores (n=95): at discharge 79% independent at discharge and 45% no/occasional pain  Adapted functional score is generic; sensitive to changes in different types of trauma patients; user- friendly and suitable for routine use and culturally relevant