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

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 data-bases 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.