Climate change and health through the lens of physical medicine and rehabilitation: A scoping review

Introduction

Physical Medicine and Rehabilitation (PM&R) physicians (physiatrists) care for patients with a variety of neurologic, musculoskeletal, chronic pain, and sports-related conditions. These conditions can cause physical disabilities, cognitive, sensory, or other functional impairments, which make these patients susceptible to the impacts of climate change. The purpose of this scoping review is to describe the existing literature at the intersection of climate change and PM&R practice, and to identify publication trends.

Methods

The search used electronic databases PubMed, CINAHL, Embase, Cochrane Library, and Web of Science to identify studies related to PM&R and climate change search terms published or in press between January 2008 to July 2023. Articles were reviewed for relevance to PM&R and climate change and were categorized into three groups: (1) Health effects of climate change, (2) PM&R interventions that address health impacts of climate change, and (3) Other relevant points of interest.

Results

A total of 38 articles met the inclusion criteria. Twenty-one articles discussed the health effects of climate change on patients encountered in PM&R practice, with most describing the negative health impacts of air pollution and increased heat. There were 13 articles regarding PM&R interventions that address health impacts of climate change, largely related to disaster preparedness or management, but also including methods for addressing heat illness, telemedicine, and a waste audit. There were four articles about other points of interest, including PM&R providers’ perceptions of climate change. Of all the included articles, there was one randomized controlled trial and the rest were observational in design. The number of studies published in the past 15 years has generally trended upwards, with the majority coming from North America.

Discussion

Climate change threatens to negatively affect the health and wellbeing of patients requiring PM&R service, and most physiatrists are concerned about this. While the number of studies has increased over the past 15 years, substantial research gaps remain in the nexus between PM&R and climate change, and several regions around the world are poorly represented in the literature. Further studies are needed to help patients with disabilities adapt to and mitigate the climate crisis.