Introduction: High energy expenditure by healthy older individuals has numerous benefits, and housework and exercises done at home are among the most common physical activities. However, there is little knowledge about how characteristics of the urban built environment could impact energy expenditure for moderate and vigorous daily activities. This study characterizes accessibility and a number of physical barriers, investigates the relationship between home environmental press and energy expenditure at home, and identifies the environmental characteristics that could explain variability in energy expenditure. Method: The home energy expenditure of 35 healthy older women was determined from retrospective geolocation data and a multi-sensor device measuring energy expenditure (SenseWear Armband V R). Barriers at home were identified with the Housing Enabler. Results: The median was 51 environmental barriers with only 7.5 barriers between the 1st and 3rd quartile, on a total of 161 possible environmental barriers of the Housing Enabler. The number of home environmental barriers was positively and moderately correlated with energy expenditure at home (r s ¼ 0.47, p ¼ 0.01). No characteristic of the home built environment was identified that could explain the variability in energy expenditure. Conclusion: Future research should identify the characteristics of the home associated with a lower or higher energy expenditure according to the characteristics of the person. This could be carried out by occupational therapists for the purpose of preventing deconditioning, energy management, promotion of social participation, recommendations for home adaptations or relocation.

Background. Although home environment assessments are commonly performed by occupational therapists working in home care, use of nonstandardized measures created in-house or lack of measure use can cast a shadow over the quality of these assessments for people with disabilities. To ensure quality of home environment assessments, occupational therapists need standardized measures with demonstrated psychometric properties. Purpose. This study provides a critical appraisal of objective accessibility measures of the home environment. Method. A systematic review was undertaken for which three databases—CINAHL, PubMed, and Embase—were searched to identify accessibility measures of the home environment and evaluate their psychometric properties. Two authors independently assessed the quality of selected studies using the critical appraisal form for psychometric articles. Findings. Ten studies discussing seven accessibility measures were identified and selected for this review. No measures showed strong evidence of both good reliability and validity. Only one study addressed the responsiveness of a measure of accessibility. Implications. As occupational therapists are specialists of the person–environment relationship, the lack of evidence of the psychometric properties of objective accessibility measures of the home environment harms evidence-based occupational therapy practice. This review identified the most promising assessment tools, but further research is needed.