Evidence map›Paper›PMID 42380867›Full record

SynthesisBMC geriatrics2026

The components and effects of home rehabilitation on activities of daily living and physical performance of community dwelling older people with low physical performance - a systematic review and meta-analysis of randomized controlled trials.

Karin Högstedt, Wilhelmus Johannes Andreas Grooten, Maria Flink, Katarina Baudin, Susanne Guidetti, Elisabeth Rydwik

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Karin HögstedtDivision of Occupational Therapy, Department of Neurobiology, Care Science & Society, Karolinska Institutet, Huddinge, Sweden. karin.hogstedt@ki.se.ORCID 0009-0004-1241-3985
Wilhelmus Johannes Andreas GrootenDivision of Physiotherapy, Department of Neurobiology, Care Science & Society, Karolinska Institutet, Huddinge, Sweden.
Maria FlinkDivision of Family Medicine and Primary Care, Department of Neurobiology, Care Science & Society, Karolinska Institutet, Huddinge, Sweden.
Katarina BaudinDivision of Occupational Therapy, Department of Neurobiology, Care Science & Society, Karolinska Institutet, Huddinge, Sweden.
Susanne GuidettiDivision of Occupational Therapy, Department of Neurobiology, Care Science & Society, Karolinska Institutet, Huddinge, Sweden.
Elisabeth RydwikDivision of Physiotherapy, Department of Neurobiology, Care Science & Society, Karolinska Institutet, Huddinge, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor people in old age, the risk of limitations in activities of daily living (ADL), low physical performance, and chronic diseases increases. Home rehabilitation targeting physical performance is a common intervention for older people with multimorbidity. Still research on home rehabilitation is mainly diagnosis specific. The objectives of this study were to summarize intervention components and evaluate the effects of home rehabilitation on ADL and physical performance in community-dwelling older people (65 years or older) with low physical performance and/or ADL difficulties.

methodsThe databases MEDLINE, Web of Science, and CINAHL (January 2006-September 2025), plus references were screened, using keywords related to aging, home rehabilitation, ADL, and physical performance in randomized controlled trials (RCTs). INCLUSION CRITERIA: RCTs of supervised home rehabilitation, targeting physical performance and/or basic and/or instrumental ADL (BADL/IADL) in community-dwelling people 65 years of age or older with low physical performance and/or ADL difficulties. EXCLUSION CRITERIA: scope of specific diagnoses, assisted living settings, centre-based, interventions areas outside the occupational therapy or physiotherapy disciplines, mainly delivered by home help service staff, exclusively outcomes outside the scope of ADL and physical performance conducted at home or non-English publications. 3,360 records were screened independently by two reviewers. Data extraction followed the PROSPERO protocol. Methodological quality was assessed using the Joanna Briggs Institute RCT checklist (2020) (JBI), and certainty of evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Random effects models generated pooled effects.

resultsThe review included 27 RCTs (n = 4,948), which were grouped into three intervention approaches. Twenty-three studies were graded as having low risk of bias, three as moderate risk of bias, and one of high risk of bias, using the JBI tool. The age of the participants ranged from 74 to 87 years of age. Activity-based interventions improved BADL (n = 1,048, SMD 0.29, 95% CI 0.17 to 0.41, P<.001; moderate evidence) but not IADL (n = 603, SMD - 0.15, 95% CI - 0.31 to 0.01) or selected ADL tasks (n = 158, non-significant). Exercise-based interventions improved BADL and physical performance (n = 310, SMD 0.43, 95% CI 0.21 to 0.66, P<.001; n = 1,472, SMD 0.20, 95% CI 0.10 to 0.30, P<.001), with low evidence due to imprecision and risk of bias according to GRADE. Reablement-based interventions showed no significant effects on selected ADL tasks measured with Canadian Occupational Performance Measure (COPM) (n = 291, COPM performance MD 0.30, 95% CI - 0.25 to 0.86; COPM satisfaction MD 0.19, 95% CI - 0.04 to 0.42) or physical performance (n = 555, SMD 0.12, 95% CI - 0.05 to 0.28), with low to very low evidence according to GRADE.

conclusionHome rehabilitation comprises three main intervention approaches. The Activity-based and Exercise-based yield small improvements in BADL and physical performance. Evidence for other ADL outcomes and the Reablement-based remains limited.

trial registrationPROSPERO (CRD42023488726).

Indexed as

Activities of Daily LivingHome Care ServicesIndependent LivingPhysical Functional PerformanceRandomized Controlled Trials as TopicAgedAged, 80 and overAging in PlaceHumansAgedHome-based rehabilitationIndependent livingOccupational therapyPhysiotherapyRandomized controlled trials as topic

Identifiers

PMID42380867
PMCPMC13321581

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.