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A Scoping Review of Physical Rehabilitation in Long-Term Care: Interventions, Outcomes, Tools*

  • Caitlin McArthur (a1), Jenna C. Gibbs (a1), Ruchit Patel (a1), Alexandra Papaioannou (a2), Paula Neves (a3), Jaimie Killingbeck (a4), John Hirdes (a5), James Milligan (a4) (a6) (a7), Katherine Berg (a8) and Lora Giangregorio (a1) (a4) (a9)...

Abstract

Residents in long-term care (LTC) often require physical rehabilitation (PR) to maintain/improve physical function. This scoping review described the breadth of literature regarding PR in LTC to date, synthesizing PR interventions that have been evaluated, outcomes used, and tools for determining service eligibility. A structured search, conducted in six licensed databases and grey literature, identified 381 articles for inclusion. Most interventions were delivered and evaluated at the resident level and typically were multicomponent exercise programs. Performance-based measures, activities of daily living, and mood were the most frequently reported outcomes. A key knowledge gap was PR in relation to goals, such as quality of life. Future studies should reflect medically complex residents who live in LTC, and length of residents’ stay should be differentiated. Intervention studies should also explore realistic delivery methods; moreover, tool development for determining service eligibility is necessary to ensure equality in rehabilitative care across the LTC sector.

Les résidents en soins de longue durée (SLD) ont souvent besoin de soins en réadaptation pour maintenir ou améliorer leur état physique fonctionnel. L’objectif de cet examen de portée était de décrire l’envergure des publications concernant la réadaptation physique en SLD jusqu’à ce jour, avec une emphase sur les types d’interventions en réadaptation qui ont été évaluées, ainsi que sur les mesures de résultats utilisées et les outils déterminant l’admissibilité au service. Une recherche structurée a été réalisée dans six bases de données sous licence et dans la littérature grise. Deux analystes ont identifié 381 articles qui ont été triés en utilisant un formulaire qui avait préalablement été testé dans un essai pilote, et les données de ces articles ont été extraites. La plupart des interventions avaient été réalisées et évaluées au niveau des résidents, et consistaient fréquemment en des programmes d’exercices à plusieurs composantes dispensés par du personnel de recherche et des physiothérapeutes. Les mesures les plus couramment rapportées étaient basées sur la performance, les activités de la vie quotidienne et l’humeur. Une lacune importante a été identifiée concernant les connaissances sur la réadaptation en lien avec des objectifs qui soient pertinents pour les résidents, tels que la qualité de vie. Dans les études à venir, il serait important que les caractéristiques des résidents en SLD soit représentatives de la complexité de l’état de santé de cette population; la durée de leur séjour devrait aussi être incluse et différenciée. Les études d’intervention devraient aussi explorer des méthodes de prestation de soins qui soient réalistes et soutenables. Le développement d’outils pour favoriser une meilleure détermination de l’admissibilité aux services est aussi nécessaire pour assurer l’égalité en matière de soins en réadaptation dans l’ensemble du secteur des SLD.

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Corresponding author

Correspondence and requests for reprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adresées à : Caitlin McArthur, MScPT University of Waterloo 200 University Avenue West Waterloo, ON N2L 3G1 <cmcarthu@uwaterloo.ca>

Footnotes

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This work was funded by a grant from Technology Evaluation in the Elderly Network, grant number KS2014-08. The authors thank Rebecca Hutchinson and Jackie Stapleton, liaison librarians at the University of Waterloo, for assistance with the database search strategy. We also thank Rebecca Clark for her assistance with data collection and analysis. We gratefully acknowledge the opportunity to collaborate with Michael Sharratt and others from the Schlegel-UW Research Institute for Aging on this project.

Footnotes

References

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