Psychological resilience is defined as the ability to cope mentally and emotionally with a crisis, or to swiftly return to pre-crisis status. Resilience as a construct is a large part of the “positive psychology” movement that focuses on the strengths of an individual when faced with adversity rather than on their weaknesses. In this context, it is generally considered a multidimensional construct consisting of behaviors, thoughts, and actions which can be learned over time. It has been demonstrated to have positive impacts on range of different processes. Resilience in the context of physical rehabilitation is a particularly fruitful line of research due to the adversity and stress that individuals are faced with following an injury, when dealing with both the trauma of the injury and their resultant impairments. This is of acute pertinence today since global needs for physical rehabilitation continue to soar 1.
One study from 2008 sought to assess the role of resilience in the rehabilitation process of individuals suffering from traumatic brain injury (TBI) or spinal cord injury (SCI). Resilience and resilient reintegration following life stressors was linked to positive outcomes in patients 2.
Another study from 2010 sought to specifically assess three different trajectories of psychological adjustment to a severe physical injury, characterized by resilience, recovery, or distress. 80 inpatients with a severe injury, consisting of a SCI or multiple traumas, were studied from a rehabilitation hospital. Data demonstrated that the most common trajectory was the resilience trajectory (54%), followed by the recovery trajectory (25%) and the distress trajectory (21%). Optimism, affect, social support, and pain had a strong impact on the different trajectories.
Understanding the factors that are associated with resilience in physical rehabilitation may help clinicians design interventions to improve patients’ adaptation 3.
Most recently, a 2022 study sought to systematically assess and describe current research on the role of resilience in the physical rehabilitation of SCI. Overall results confirmed, again, that resilience positively impacts physical outcomes 4.
Interestingly, resilience also improves the well-being, and likely therefore quality of care, of physiotherapists as well. During the COVID-19 pandemic, data revealed that physiotherapists with higher resilience experienced the pandemic with fewer symptoms of depression, anxiety and stress. In addition, the psychological symptoms of posttraumatic stress disorders may be less pronounced among resilient physiotherapists 5.
The relationship between resilience and positive outcomes for physical rehabilitation patients continues to warrant additional research with more standardized research measurements and methods. In particular, it is critical to develop a consistent definition of resilience. A clearly delineated construct would then facilitate the creation of valid and reliable measures of resilience as well as assist with the creation of interventions to improve patient wellbeing following a traumatic event 2. This will pave the way to understanding and facilitating the critical factors that can boost resilience and help patients cope with physical rehabilitation.
References
1. Jesus, T. S., Landry, M. D. & Hoenig, H. Global need for physical rehabilitation: Systematic analysis from the global burden of disease study 2017. Int. J. Environ. Res. Public Health (2019).
doi:10.3390/ijerph16060980
2. White, B., Driver, S. & Warren, A. M. Considering Resilience in the Rehabilitation of People With Traumatic Disabilities. Rehabil. Psychol. 53, 9–17 (2008). doi:10.1037/0090-5550.53.1.9
3. Quale, A. J. & Schanke, A.-K. Resilience in the Face of Coping With a Severe Physical Injury: A Study of Trajectories of Adjustment in a Rehabilitation Setting. (2010). doi:10.1037/a0018415
4. Norwood, M. F., Lakhani, A., Hedderman, B. & Kendall, E. Does being psychologically resilient assist in optimising physical outcomes from a spinal cord injury? Findings from a systematic scoping review. Disabil. Rehabil. 44, 6082–6093 (2022). doi: 10.1080/09638288.2021.1952320
5. Pigati, P. A. da S., Righetti, R. F., Nisiaymamoto, B. T. C., Saraiva-Romanholo, B. M. & Tibério, I. de F. L. C. Resilience and its impact on the mental health of physiotherapists during the COVID-19 pandemic in São Paulo, Brazil. J. Affect. Disord. 310, 422–428 (2022). doi: 10.1016/j.jad.2022.05.049