Integration of physical activity in reablement for community dwelling older adults: a systematic scoping review

Abstract

Introduction: Reablement is a rehabilitative intervention provided to homecare receivers (mostly older adults) 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.Objective: 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 apriori protocol was published. Studies investigating or exploring time-limited (within 6 months), interdisciplinary reablement for community-dwelling older adults, published in English, Norwegian, Danish, Swedish and German were considered for inclusion. PubMed, Cochrane central register of controlled trials, Embase, PsycINFO, AMED, PEDro, CINAHL and Google Scholar were searched for studies published between 1996 and July 2019, in addition to reference and citation searches. Study selection and data extraction were made independently by two reviewers.Results: Forty-three studies were included. Exercise strategies and practice of daily activities were reported to be included in the majority of intervention studies, but in most cases, no information was provided about the degree or intensity of which PA was involved, or how PA interventions were targeted to individual needs. Interventions aiming to increase general PA levels or reduce sedentary behavior were rarely described. None of the studies explored older adults’, health care 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 regarding how PA is integrated in reablement, including how PA strategies are 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.

Economic Evaluation of a Reablement Training Program for Homecare Staff Targeting Sedentary Behavior in Community-Dwelling Older Adults Compared to Usual Care: A Cluster Randomized Controlled Trial

“… 23–28 These latter groups may have greater potential for improvement and thus may benefit more from reablement, particularly in terms of healthcare utilization and associated costs, as they generally require temporary rather than long-term support. 63 In terms of effect ¸ previous research on reablement has not yet examined sedentary behavior, 64 and uncertainty has often been reported regarding the effect on HRQoL. 18 , 19 This may be explained by the use of generic outcome measures, such as the EQ-5D, which do not account for benefits beyond health, such as well-being and independence.…”

Effectiveness of a reablement training program for homecare staff on older adults' sedentary behavior: A cluster randomized controlled trial

“…(physical) functioning, increase or maintain their independence in meaningful activities of daily living, and reduce their need for long-term services. 12 The effect of reablement interventions on sedentary behavior has not yet been investigated, 13 and research of varying methodological quality 14 has yielded inconsistent findings on other outcomes, such as daily, [15][16][17] physical, [18][19][20] and psychological functioning, 21,22 and falls. 23,24 This highlights the need for more methodologically robust trials to support or refute the effectiveness of reablement.…”

Investment Decisions on Physical Activity Promotion: A Locality Case Study in Complex Public Health Policy Making

“…On this basis, an 'active living' policy frame emerged in the late-1990s that fore-grounded 'everyday' PA such as walking and gardening (Eyler et al, 2013). From this foundation, policy then extended into novel domains such as: mental health benefits associated with PA (Asztalos et al, 2009); contributions to environmental sustainability via 'active transportation' (Sallis et al, 2004); and interventions across the whole lifecycle, particularly the '(re)enablement' of older people (Mjøsund et al, 2020). This plurality became rooted in global PA policy (WHO, 2018), expressed as a 'whole systems' approach (Rutter et al, 2019).…”