A Systematic Review of Rehabilitation Interventions Targeting Participation in Young Adults with Disabilities

Abstract

Background: Youth living with chronic disabilities face challenges in various life domains, and effective rehabilitation services are essential in providing the necessary support to optimize their participation in the community. To date, there has not been any systematic review summarizing rehabilitation intervention studies that targeted this vulnerable population and their participation in various societal domains. Aim: The purpose of this comprehensive review was to identify and critically appraise studies that aimed to improve participation outcome in young adults. Design: Systematic review Settings: Rehabilitation facilities, home, school, community, other Population: Young adults with disabilities Method: Systematic search in OVID MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Knowledge Social Sciences Index (2000 to 2013). The International Classification of Functioning, Disability and Health (ICF) were used to classify the focus and outcome of the interventions. Results: 104 multidisciplinary intervention studies were identified of which only 9 had a randomized design. Two of the randomized trials had a particular focus on young adults, one of which demonstrated a positive effect on the measured outcome as a result of the intervention. The review also revealed that studies targeting young adults often included subjects with multiple disabilities, had less focus on the ICF category “body functions” and evaluated a broader spectrum of participatory outcomes compared to studies including broader age categories. The majority of the studies did not explicitly illustrate the linkage between the applied interventions and the outcome measures or describe the processes of the interventions that might have affected the results. Furthermore, only 27% or the studies manipulated the environmental context as part of the interventions. Conclusions: In this review, only one third of the multidisciplinary intervention studies specifically targeted young adults, while the other studies included a wide age range. Very few studies were designed to be able to evaluate the outcome as a direct result of the applied intervention or described the specific elements involved in the interventions. This is of vital importance in the design and delivery of effective rehabilitation services and in enabling efficient Trans disciplinary communication in this complex field. Clinical Rehabilitation Impact: The ICF framework was found to be useful in this review for the classification of the components and outcomes in intervention studies. This framework may also provide a common language for the implementation of rehabilitation interventions. However, better description and classification of the processes involved in rehabilitation interventions and their impact on outcomes are still needed in both research and clinical practice.