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Home‐ and Community‐Based Occupational Therapy Improves Functioning in Frail Older People: A Systematic Review
Author(s) -
De Coninck Leen,
Bekkering Geertruida E.,
Bouckaert Leen,
Declercq Anja,
Graff Maud J. L.,
Aertgeerts Bert
Publication year - 2017
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14889
Subject(s) - medicine , occupational therapy , activities of daily living , fear of falling , systematic review , meta analysis , psychological intervention , strictly standardized mean difference , gerontology , randomized controlled trial , physical therapy , medline , poison control , injury prevention , psychiatry , environmental health , surgery , political science , law
Objectives The objective is to assess the effectiveness of occupational therapy to improve performance in daily living activities in community‐dwelling physically frail older people. Design We conducted a systematic review and meta‐analysis. We included randomized controlled trials reporting on occupational therapy as intervention, or as part of a multidisciplinary approach. This systematic review was carried out in accordance with the Cochrane methods of systematic reviews of interventions. Measurements Meta‐analyses were performed to pool results across studies using the standardized mean difference. The primary outcome measures were mobility, functioning in daily living activities, and social participation. Secondary outcome measures were fear of falling, cognition, disability, and number of falling persons. Results Nine studies met the inclusion criteria. Overall, the studies were of reasonable quality with low risk of bias. There was a significant increase in all primary outcomes. The pooled result for functioning in daily living activities was a standardized mean difference of −0.30 (95% CI −0.50 to −0.11; P = .002), for social participation −0.44 (95% CI −0.69, −0.19; P = .0007) and for mobility −0.45 (95% CI −0.78 to −0.12; P = .007). All secondary outcomes showed positive trends, with fear of falling being significant. No adverse effects of occupational therapy were found. Conclusion There is strong evidence that occupational therapy improves functioning in community‐dwelling physically frail older people.