Integration of Physical Activity in Reablement for Community Dwelling Older Adults: A Systematic Scoping Review

Abstract

Background

Reablement is a rehabilitative intervention provided to homecare receivers with the aim of improving function and independence. There is limited evidence of the effectiveness of reablement, and the content of these interventions is variable. Physical activity (PA) is known to be important for improving and maintaining function among older adults, but it is unclear how PA is integrated in reablement.

Purpose

To map existing evidence of how PA strategies are integrated and explored in studies of reablement for community dwelling older adults and to identify knowledge gaps.

Methods

An a priori protocol was published. Studies of time-limited, interdisciplinary reablement for community-dwelling older adults were considered for inclusion. Eight databases were searched for studies published between 1996 and June 2020, in addition to reference and citation searches. Study selection and data extraction were made independently by two reviewers.

Results

Fifty-one studies were included. Exercise strategies and practice of daily activities were included in the majority of intervention studies, but, in most cases, little information was provided about the intensity of PA. Interventions aiming to increase general PA levels or reduce sedentary behavior were rarely described. None of the studies explored older adults’, healthcare providers’ or family members’ experiences with PA in a reablement setting, but some of the studies touched upon themes related to PA experiences. Some studies reported outcomes of physical fitness, including mobility, strength, and balance, but there was insufficient evidence for any synthesis of these results. None of the studies reported PA levels among older adults receiving reablement.

Conclusion

There is limited evidence of how PA is integrated and targeted to older adults’ individual needs and preferences in a reablement setting. The feasibility and effectiveness of PA interventions, as well as experiences or barriers related to PA in a reablement setting, should be further investigated.

Keywords:

• rehabilitation
• exercise therapy
• health services for the aged
• aged
• 80 and over
• physical fitness
• health personnel

Abbreviations

PA, physical activity; HCP, healthcare providers; PT, physiotherapist; OT, occupational therapist; RN, registered nurse; TUG, timed up and go; SPPB, short physical performance battery; STS, sit-to-stand; PASE, Physical Activity Scale for the Elderly; RCT, randomized controlled trial.

Data Sharing Statement

All data generated or analyzed during this study are included in this published article and its Supplementary Files 1 and 2.

Acknowledgments

We thank Marit Veie, specialist librarian at Nord University, Norway, for guidance in the development of the search strategy and assistance with performing searches in scientific databases.

Author Contributions

HLM carried out searches (in cooperation with a librarian), did study selection, data extraction, mapping of results, and made a draft of the manuscript. CFM carried out duplicate study selection and data extraction. EB and LU were involved to solve discrepancies between reviewers. All authors contributed to data analysis, drafting, or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

None of the authors participating in the review (HLM, CFM, EB, and LU) have any competing interests.

Additional information

Funding

This study is part of a PhD project undertaken by the first author, HLM, and funded by Nord University, Norway. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.