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Descriptive Epidemiology of Typical Physical Disabilities in Medina: A Clinic-Based Study

Abu Zeeshan Bari, PhD, Department of Prosthetics Orthotics, College of Medical Rehabilitation Sciences, Taibah University. KSA Abdullah Mohammad Al -Shenqiti Dean Faculty of Medical Rehabilitation Sciences, Taibah University, Al Madinah Al Munawwarah,, KSA Mohammad Shehzad Hassan Department of Prosthetics Orthotics, College of Medical Rehabilitation Sciences, Taibah University, Al Madinah Al Munawwarah KSA Muhammad Naveed Ahmed Department of Prosthetics Orthotics, College of Medical Rehabilitation Sciences, Taibah University, Al Madinah Al Munawwarah, KSA


Introduction
The international classification of Functioning, Disability and Health (ICF) considers disability to be a multidimensional term that includes impairment, activity and functional limitations. As such, individuals during the course of their lives may experience disability, leading to a short-term or a log-term functional impairment, which can worsen with aging. 1 Rehabilitation has proven to be an effective measure to reduce age-related disabilities and to improve functional impairment. 2 However, a global consensus on the operational measures of disability as well as the need for rehabilitation services has not yet been reached. This knowledge gap must therefore be filled through region-or population-specific studies on the prevalence of disabilities; in particular, it can be filled through surveys designed for specific disabilities such as physical, neurological or psychological disabilities.
Carefully designed surveys for disability measurement provide evidence that enables disability policy-makers in a given country or region to make updated decisions on disability policies and programmes. The prevalence of disability globally is estimated to be 15% 1 ; however, there is a significant variation in this figure in different countries, 3 which is attributed to factors such as study design and methodology, individuals' personal circumstances and environmental factors. 1, 4, 5 Therefore, the prevalence of disability globally cannot be relied upon for policy-and decision-making. Data on disability prevalence must be collected and analysed specifically for each region.
Disability is one of the most significant socioeconomic issues in the Kingdom of Saudi Arabia. 6 Although some published research has addressed the epidemiology of disabilities at the national level, 6,7 the reported data is limited to identifying the prevalence of specific types of disabilities. Due to a dearth of research publications providing sociodemographic data of patients receiving physical medicine and rehabilitation care in the kingdom, it is difficult to estimate the availability of resources and challenges pertaining to the rehabilitation care in this region. According to the General Authority of Statistics, KSA 8 , the total population of Al-Madinah Al-Munawwarah region in 2017 was 2.1 million, where the total number of Saudi nationals is 2.0 million. The Medical Rehabilitation Hospital in the city of Medina is the only public-sector rehabilitation hospital having a bed capacity of 141. Therefore, it became imperative that data be collected for patients receiving rehabilitation care in the city of Medina, at the Medina rehabilitation hospital. Following statistical analysis, such data would help facilitate the development of a demographic profile of patients, to identify the needs of the physical rehabilitation aids and to arrange for the relevant expertise and equipment to serve the needs of such patients.

Methods & Material Subjects
The study was carried out at the Medical Rehabilitation Hospital, Median during the year 2018 and describes the sociodemographic profile of the patients who were referred by their primary care physicians and consultants to the hospital. The hospital is staffed with an occupational therapist, a physical therapist and two Prosthetists and orthotics. The data extraction was carried out for a five-year period ranging from 2013 till 2017 through the patients' prescription forms, collected by the hospital. The statistical analysis was carried out using SPSS 21.0 A preliminary Levene's test for equality of variances indicated that the variances in ages Disabilities in Medina of the male and female groups were significantly different; a two-sample t-test was performed that does not assume equal variances.

Results
Over the five-year study period, 1305 patients visited the hospital for a multitude of physical rehabilitation needs; of these, 577 (44.2%) were female (Table 1).

Disabilities in Medina
The mean age of female patients for each age group was found to be greater than the mean for the entire period ( Figure 2). The mean age of the entire population increased linearly over the study period. The same trend of an increasing mean age for each age group was observed when the data was stratified into males and females.

Discussion
The total number of female patients over the entire study period was found to be less than the total number of male patients. However, male children with physical disabilities was the largest group amongst all the patients. A nonlinear trend in relation to patients visiting the hospital was found for the entire study period; due to this trend, it is difficult to make an accurate prediction of the number of patients who might be in need of rehabilitation aids in the near future. Nevertheless, a conservative estimate can still be made based on the available data. On average, the number of patients in the age group of younger patients (age 31-50) were found to be more than any other age group. This could be related to a multitude of factors, and requires further in-depth study of the specific reasons why the patients require physical rehabilitation. This sort of study may help to identify the causes of physical rehabilitation needs in a younger population and help to develop measures to prevent such causes from happening. A comparison between the mean ages of the female and male populations indicated that the mean age of male patients was lower. Considering the trauma cases in the Kingdom, this may pertain to traumatic injuries; however, as mentioned earlier, further exploration is needed for this hypothesis to be conclusive.

Conclusions
Disability is one of the root causes that adversely affects the socioeconomic development of the Kingdom. This study explores the demographic profile of patients who were in need of rehabilitation care at the Medical Rehabilitation Hospital, Medina, Kingdom of Saudi Arabia, for a period of five years. The higher number of younger male patients highlights the need for an in-depth study for the prevalence and causes of specific physical disabilities in order to improve the situation and minimise the resources required of physical rehabilitation care.