Community-based Rehabilitation Program Research Articles

Employment Among Women with Severe Mental Illness Availing Rural Community-based Rehabilitation Program: A Qualitative Study from South India

Background: Women in India are often disadvantaged in accessing education, employment, health services, and decision-making within families. This inequality is particularly pronounced among women with severe mental illness, especially those from rural areas. Methods: The study explored the employment status, facilitators, and barriers to employment among women with severe mental illness availing a rural community-based rehabilitation (CBR) program in Jagaluru, South India. Interviews were conducted with 15 women, their family caregivers, the CBR program social worker, and a community program coordinator of a nongovernmental organization partner. The study used a qualitative research design. Thematic analysis was used to identify emerging themes. Results: Ten women were employed. Among five unemployed women, two independently took care of household responsibilities, and one assisted the family. Medication compliance and the desire to earn money for oneself were significant facilitators. Employment opportunities for some women were hindered by poor bus connectivity in interior villages, patriarchal familial attitudes, and challenges in availing loans for livelihood ventures. Conclusion: Rural families access treatment for severe mental illness when it is available at the nearest government health facility. With symptom improvement, many women could avail themselves of local employment opportunities without additional inputs from the CBR team.

Community-based Rehabilitation Support Programmes and Social Inclusion of Persons with Disabilities in Tigania East, Kenya

Community-based rehabilitation programmes (CBR) are considered fundamental in improving the well-being of persons with disabilities by facilitating access to basic services like healthcare, education, housing, and employment and fostering their participation in the community through the transfer of knowledge and skills concerning disability and rehabilitation to people with disabilities, their families and the community at large to enhance social inclusion. However, despite the existence of the Disability Community programmes, it is not clear how community-based rehabilitation support has fostered the social inclusion of persons with disabilities in Kenya. Based on the data from Tigania East, Meru County, Kenya, this paper explores the impact of community-based programmes on the social inclusion of persons with disabilities with a view to influencing policy formulation to foster livelihood and inclusion of the disability in the community agenda.

Co-Designing a Community-Based Cardiac Rehabilitation Program for Chinese Migrants in Australia: A Mixed Method Study

Co-Designing a Community-Based Cardiac Rehabilitation Program for Chinese Migrants in Australia: A Mixed Method Study

Utilization Community-Based Rehabilitation Methods to Improve Independence and Quality of Life for Patients with Disabilities in Nara Phirom Health Promoting Hospital, Thailand

The disability community activity, Nara Phirom Health Promoting Hospital in Banglen District, Nakhon Pathom, Thailand, collaborated with the Faculty of Physiotherapy, Mahidol University to support the disability community. Using the Community-based rehabilitation (CBR) method, the aim to enhance independence and quality of life. Evaluation includes IADL for independence and WHOQoL Bref-100 for quality of life. Education on health, immobilization, and exercise was provided to patients, families, and caregivers. Therapists teached physical exercises, to be repeated 2-3 times daily by caregivers and family. The 1-month program, supervised by therapists, includes standing and walking for patients with lower extremity strength of 3/5 (measured by manual muscle testing). Rehabilitation involves crafting items like wallets and bags, stamps, and flowers from bottles. Results, patients with low function status (very dependent on other people) decreased by 64.3%, moderate function increased by 116.7% and independence increased by 111.1%. There was a significant improvement in quality of life (WHOQoL) and all domains after CBR program.

Barriers and enablers to help seeking, treatment adherence and recovery among community-based drug rehabilitation clients in the Philippines

Background This study aimed to determine factors influencing help-seeking, accessing treatment and sustaining recovery among Filipino PWUDs during the country’s war against drugs. Methods Purposive sampling was used with respondents recommended by program managers or community facilitators of community-based drug rehabilitation programs. In-depth interviews with clients and their families were conducted in 17 local government units across 8 regions in the Philippines. Transcripts were analyzed using Nvivo 12. Results The results highlight barriers to help-seeking, including the PWUDs’ belief that they don’t need help, fear of police and incarceration, stigma and discrimination. Enablers to help seeking and treatment adherence were motivation to change, accessible treatment options and family support. Community acceptance, quality of care of service providers, and support of community leaders enabled both help-seeking and recovery. Conclusion The findings suggest the impact of a punitive approach and the need to reframe drug use as a health issue. Results also suggest the need to reduce stigma and discrimination and promote positive messaging to enable help-seeking, adherence, and recovery.

The Effect of Restorative Justice for Drug Users on The Overcapacity of Correctional Facility in Solo City

The problem of drug abuse has become a major challenge in many countries, causing the number of prisoners addicted to narcotics to increase and causing overcrowding in prisons. This article discusses the influence of restorative justice as an innovative solution in dealing with drug users and overcrowding in correctional facility. Restorative justice replaces the traditional punishment-focused approach with one that is oriented towards rehabilitation, reconciliation, and the active participation of drug users in the rehabilitation process. In addition, restorative justice can help reduce overcrowding in prisons by reassessing the detention approach to drug users. Alternatives such as community-based rehabilitation programs and electronic monitoring could be implemented to alleviate pressure on the overcrowded prison system. By combining restorative justice and prison reform, governments can create more sustainable and humane solutions to the complex challenges of drug addiction.

Disability and functional status among patients post Covid 19 - A tertiary care hospital based prospective study

BackgroundThe long-term sequelae of COVID-19 infection, the persistence of disability, its temporal profile, and associated factors remain under-documented in South India. ObjectivesTo estimate the proportion of disability in survivors of COVID-19 at different time points (first, second, and sixth months) and determine the demographic and clinical variables associated with poor functional status which will aid in developing effective treatment and rehabilitation strategies. MethodsA total of 139 COVID-19 patients were interviewed at discharge from a tertiary care hospital and followed up in the first, second, and sixth months. Persistent symptoms and post-COVID functional status (PCFS) scores were recorded at all these time points. Univariate and Multivariate Poisson regression analysis was used to determine the association of socio-demographic variables and other clinical factors with functional status post-COVID-19. Results48.92 % of patients had complete recovery. However, a majority (51.08 %) experienced persistent functional limitation - 33.81 % had negligible, 15.83 % mild, 0.72 % moderate, and 0.72 % severe limitation. Common symptoms at six months were breathlessness (23.02 %), fatigue (20.14 %), memory loss (10.07 %), myalgia (8.63 %), and post-traumatic stress disorder (7.91 %). Vaccination emerged as a significant predictor of disability status (p < 0.05). Taking two vaccine doses lowered the risk of disability by 0.48 times. ConclusionAt the six-month follow-up of discharged COVID-19 patients, they continue to exhibit persistent functional limitations and symptoms. Administration of two vaccine doses is recommended to improve functional status at six months. Multidisciplinary clinics, telemedicine, and community-based rehabilitation programs are essential to minimize post-COVID-19 functional disability and facilitate complete recovery.

"They Just Love Me"-An Examination of Social Support Experiences and Values Among People With TBI.

Social support is important for health and functional outcomes after traumatic brain injury (TBI), but many adults with TBI report inadequate social support. Little research has examined the social support priorities of adults with TBI or what an optimal social support network should include. The objective of this study was to describe the social support structures and experiences of adults with TBI. Community-based rehabilitation program. Community-dwelling adults with TBI, predominantly from racial and ethnic minority groups. Cross-sectional collection of quantitative and qualitative data. Number of close social contacts and total social contacts, along with a report of the frequency of social support using the Medical Outcomes Study Social Support Survey. Qualitative interviews were used to examine the quality of social support and participant values and priorities. Participants had an average of 4.3 close contacts (median 3.5, range 1-10), an average of 8.5 total social contacts (median 7, range 2-28), and a low frequency of social support (mean 28.4, SD=24.7). Interview themes fell under 2 grand themes: structure of social networks (social networks are made up of families; proximity influences the type of support) and quality of social support (commitment vs indifference; doing things with and for others adds meaning; and "they just love me"). Participants in this study had small social networks and a low frequency of social support. Findings suggest that people with TBI value committed support partners, social inclusion, bidirectional relationships, and emotional connection, yet experience lower support in these areas compared to tangible support. Future research should examine how to adapt existing models of social support to more closely align with participant values. Rehabilitation services may need to focus more heavily on individual and family training, addressing strategies to develop and maintain relationships, emotional connection, and communication to enhance relationship and social support quality.

Community-Based Drug Rehabilitation Clients’ Motivation, Satisfaction and the Factors Affecting their Completion of the Rehabilitation and Aftercare Program: A Convergent Mixed Methods Study

This study examined treatment motivation, clientele satisfaction, and the factors affecting enrollment and completion in community-based drug rehabilitation and aftercare programs in the Philippines. A convergent mixed methods research design was employed using a survey and qualitative focus group discussions. Both on-going and completed clients had high level of internal motivation towards treatment and were highly satisfied with the program. Clients reported internal and external factors influenced their completion of the rehabilitation program while their satisfaction determined the areas that require necessary improvements. Aside from internal and external motivation, the general structure of the program, competence of facilitators, government and community support, and complementary intervention serve as influential factors.

The Priority Goals and Underlying Impairments Contributing to Goal-Related Problems of People with Parkinson's Disease Receiving a Community-Based Rehabilitation Program.

Goal setting is a core rehabilitation practice in Parkinson's disease (PD). Targeting therapy towards specific goals leads to greater improvements in performance and psychosocial outcomes. Goal setting in PD is feasible, and although the nature of goals has been described in previous studies, the underlying impairments related to goals have not been described. Understanding the nature of goals ensures that interventions for people with PD are aligned with their needs and priorities. Understanding the underlying impairments highlights which symptoms have the biggest impact on daily life and is necessary for planning appropriate interventions to target them. To describe the nature of the goals of people with PD; the underlying impairments related to goals; and to compare differences between high and low priority goals. Deductive content analysis was used to map goal statements to the international classification of function (ICF) activity and participation category and to map therapist field notes detailing the primary underlying impairment to the ICF Body Functions category. These results were then compared across goal priority rankings. 88 goals of 22 people with PD were analysed. We found that people with PD set diverse goals across all chapters of the ICF Activity and Participation category, with "self-care" goals making up the highest proportion of goals. The primary underlying impairment related to the goals was predominantly related to impairments in "mental functions" under the Body Functions category. Regardless of goal priority, most goal-related underlying impairments were found to be in the "mental functions" category. The goals of this sample of community-dwelling people with PD highlight their diverse needs and priorities. These findings indicate that nonmotor symptoms, namely, executive dysfunction and amotivation most commonly impact the performance of and participation in activities of greatest importance to people with PD. This trial is registered with ACTRN12621001483842.

Answering the Rehabilitation 2030 Call.

In 2017, the World Health Organization initiated a global effort to improve rehabilitative services by 2030, with the overall goal of helping individuals with disabilities achieve maximal independence and improved well-being. Though more than 1 billion people worldwide live with a disability, a significant portion do not have access to appropriate rehabilitative services. In low-income countries, such as Zambia, where rehabilitative services are greatly lacking, disability can further exacerbate economic disparities in the context of personal, cultural, and environmental factors that limit participation in society. Therefore, expansion of rehabilitative services in low-income countries is a pressing global need, and such efforts must be tailored to the societal and cultural framework in which they are implemented. Community-based rehabilitation programs are uniquely poised to provide services in similar low-to-middle-income countries as they eliminate travel barriers to care, allow for regular follow-up, and address the societal determinants of disability by encouraging greater community engagement and by decreasing cultural stigma around disability. Special Hope Network (SHN), a community-based rehabilitation organization in Lusaka, Zambia that serves families caring for children with physical and cognitive disabilities, represents a cost-effective, sustainable, and culturally practical model to provide rehabilitative care. We propose this organization's model as one that can be reproduced and expanded upon in other low-to-middle-income countries to answer the World Health Organization's call to action.

Enhancing Community Resilience: An Integrated Home-based Psychological Intervention for Individuals Living with Physical Disabilities

Individuals living with physical disabilities more likely develop psychological problems and less able to seek appropriate care for their issues as compared with the individuals living without disability. This study aimed to assess the effectiveness of an integrated home-based psychological intervention in managing psychological problems among individuals living with disabilities. For the purpose, a total of 60 participants were enrolled from the Community-Based Rehabilitation (CBR) program at Aid to Leprosy Patients (ALP) in Rawalpindi Pakistan between November 2021 and July 2022. These participants received comprehensive rehabilitation services alongside a structured psychological intervention. The duration of the study was 5 months including the follow up sessions. Significant improvements observed from pre-treatment to post-treatment. The main effect for psychosocial disabilities was (F = 116.93, p&lt;.001), emotional problems (F = 116.93, p&lt;.001), Depression (F = 117.30, p&lt;.001), Anxiety (F = 150.02, p&lt;.001) and Stress (F = 93.36, p&lt;.001). The integrated home-based psychological intervention served as an effective rehabilitation approach for individuals with physical disabilities, particularly those previously unable to reintegrate into community life.

Adoption of community-based land rehabilitation programs (CBLRP) and its effect on livelihoods in Offa district, south Ethiopia

Land degradation is a major issue in Ethiopia and has a significant impact on agriculture and subsistence. Community-based land restoration projects are essential to address this issue. This study aimed to evaluate the implementation of a community-based land restoration programs and its impact on livelihoods in the Offa District of south Ethiopia. Four Kebeles were randomly selected for the study and 133 household heads (52 program participants and 81 non-participants) were selected using a simple random sampling method. Data was collected by using an interview schedule, focus-group discussions, and key informant interviews. Data were analyzed using a binary logistic regression model, propensity score matching, participation index (PI), t-test, and chi-square test. The results showed that the implemented land rehabilitation measures had higher crop production and farm income for most adopter households compared to their counterparts. The logistic regression model revealed that the slope of farmland, gender of household heads, family size, perception of rehabilitation, access to training, and farm experience positively influenced household participation in the community-based land rehabilitation programme (CBLRP) in the study area. However, the age of the respondents, access to education, size of farmland, frequency of extension contact positively and ownership of livestock negatively influenced household participation. Propensity score matching revealed that CBLRP resulted in higher crop output and farm revenue for most participating families than counterparts. Based on these findings, it is recommended that agricultural and rural development offices, non-governmental organizations, and other stakeholders should consider the factors that influence household participation in rehabilitation programs in the study area to effectively address the issue of the households’ participation at various levels of rehabilitation programs.

Community-Based Drug Recovery Program Social Services in Disruptive Times: Experiences of Person Who Use Drugs in Palawan, Philippines

The restricted movements during the COVID-19 pandemic have created challenges for people who use drugs (PWUDs) to access and complete community-based drug rehabilitation program (CBDRP) social services. This study aims to investigate the experiences of PWUDs undergoing CBDRP in Palawan, Philippines during disruptive times such as the COVID-19 pandemic with a focus on the changes in the social service support mechanisms enabling PWUDs to continue in their recovery. 188 PWUDs undergoing CBDRP in the 11 municipalities of Palawan participated in focus group discussions between July to December 2022. Participants were asked about the effects of the consequences of the COVID-19 pandemic such as social isolation; modification in the CBDRP social services delivery and accessibility; shifting focus of the CBDRP in-charge officers; and changing family dynamics. Transcripts were analyzed using thematic analysis and it revealed four themes: (1) Experiences of PWUDs on CBDRP social services support mechanisms as against as planned; (2) Challenges in completing CBDRP; (3) Leadership initiatives observed by PWUD; and (4) Role of local groups and PWUDs’ family in the recovery of PWUDs during COVID 19 pandemic. The study demonstrates a need for a holistic care approach with psychosocial needs support services; enhanced family and community engagement; sustainable livelihoods programs; digital transformation and digital engagement; and capacitating the social service providers particularly those at the barangay level and local groups as vital factors for better CBDRP delivery. Further, the study exposed the necessity for data-driven and context-specific policies flexible and agile enough to enable better social services delivery, community participation, and effective implementation. Keywords: community-based drug program, social services, person who uses drugs, COVID-19, public policy

Community-based rehabilitation services implemented by multidisciplinary teams among adults with stroke: a scoping review with a focus on Chinese experience

BackgroundDespite the growing interest in hospital rehabilitation services for communities, studies on existing community-based rehabilitation (CBR) services remain scarce owing to limitations in the development of community health services and regional cultural diversity. As a guaranteed measure for ensuring the quality of rehabilitation services and achieving the desired service outcomes, clear roles and responsibilities in multidisciplinary teams and effective service delivery are particularly important.ObjectiveThis scoping review aimed to determine the scope of community stroke rehabilitation programs involving existing multidisciplinary teams and to analyze the implementation content and implementers’ functional roles to provide guidance for future CBR programs.MethodsThe scoping review design followed the methodology of the Joanna Briggs Institute and was based on the normative scoping review framework proposed by Arksey and O’Malley. The comprehensive CBR framework was proposed by World Health Organization-guided data charting and analysis.ResultsOf the 22,849 identified citations, 74 studies were included, consisting of 6,809 patients with stroke and 49 primary caregivers, most of whom were from China. The most common working mode in CBR programs was a dual approach involving both healthcare professionals in medical institutions and community healthcare professionals. The number of programs in each discipline was in the following descending order: nursing, medical care, rehabilitation, psychology, nutrition, and public health. Among these, multidisciplinary teams comprising medical, nursing, and rehabilitation disciplines were the most common, with a total of 29 programs. Disciplinary members were mainly responsible for implementing their respective disciplinary content, with physicians providing guidance for the programs. More than 82.4% of the studies reported 2–4 intervention strategies. The intervention forms of rehabilitation content were the most diverse, whereas preventive interventions were more homogeneous than others. Physical function and socio-psychological measurements were the most commonly reported outcomes.ConclusionCBR services implemented by multidisciplinary teams can effectively achieve functional and emotional improvement in patients with stroke, and nurses are the most involved in implementation, especially in community settings. The results further emphasize the importance of strengthening the exploration of nurses’ maximum potential to implement CBR plans in future practice.Trial registrationThe registration information for this scoping review can be found at osf.io/pv7tg.

Barriers and facilitators for increased accessibility to quality rehabilitation services in low- and middle- income countries: a systematic review.

With an increasing number of people experiencing limitations in functioning during their life course, the need for comprehensive rehabilitation services is high. In 2017, the WHO Rehabilitation 2030 initiative noted that the need for the establishment and expansion of rehabilitation services is paramount in order to obtain well-being for the population and to ensure equal access to quality healthcare for all. The organization of rehabilitation services is however facing challenges especially in low-and middle-income countries with a very small proportion of people who require rehabilitation actually getting them. Various surveys conducted in low-and -middle income countries have revealed existing gaps between the need for rehabilitation services and the actual receipt of these services. This systematic review aimed to determine the barriers and facilitators for increasing accessibility to rehabilitation services in low- and middle-income countries. Recommendations for strengthening rehabilitation service organization are presented based on the available retrieved data. In this systematic review, an electronic search through three primary databases, including Medline (PubMed), Scopus and Web of Science (WOS) was conducted to identify original studies reporting on barriers and facilitators for rehabilitation service organization in low-and middle-income countries. Date of search: 25th April 2021 (PubMed), 3rd May 2021 (Scopus and Web of Science). All studies including barriers or/and facilitators for rehabilitation services in low- and middle income countries which were written in English were included in the review. The articles written in other languages and grey literature, were excluded from this review. Total of 42 articles were included from year 1989 to 2021. Numerous barriers were identified that related to education, resources, leadership, policy, technology and advanced treatment, community-based rehabilitation (CBR), social support, cultural influences, political issues, registries and standards of care. National health insurance including rehabilitation and funding from government and NGOs are some of the facilitators to strengthen rehabilitation service organization. Availability of CBR programs, academic rehabilitation training programs for allied health professionals, collaboration between Ministry of Heath (MOH) and Non-governmental Organizations (NGOs) on telerehabilitation services are amongst other facilitators. Recommendations for improving and expanding rehabilitation service organization include funding, training, education, and sharing of resources.

Effectiveness of Community-Based Rehabilitation (CBR) Centers for Improving Physical Fitness for Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.

To synthesise the best available evidence for the effectiveness of interventions delivered in community-based rehabilitation (CBR) centers on physical fitness, for community-dwelling older adults living in Asian countries. This study is a systematic review and meta-analysis. Seven English and two Chinese electronic databases were searched for randomised controlled trials (RCTs) and quasi-experimental studies that were conducted by centers providing CBR. Independent reviewers screened, quality-appraised and extracted data. The primary outcome was physical fitness measured by validated assessment tools, including the Timed Up and Go Test (TUG), gait speed, hand grip strength, Functional Reach Test (FRT), and one-leg standing test. Assessments of activity of daily living and quality of life using tools including the Barthel Index, Short Form (SF)-12, and SF-36 were secondary outcomes. After screening 5,272 studies, 29 studies were included (16 RCTs, 13 quasi-experimental studies) from four countries. Meta-analyses found that CBR programs significantly decreased TUG time (mean difference [MD], -1.89 seconds; 95% confidence interval [95% CI], -2.84 to -0.94; I2=0%; Z=3.90, p<0.0001), improved gait speed (MD, 0.10 m/s; 95% CI, 0.01-0.18; I2=0%; Z=2.26, p=0.02), and increased one-leg standing time (MD, 2.81 seconds; 95% CI, 0.41-5.22; I2=0%; Z=2.29, p=0.02). Handgrip strength and FRT showed no statistically significant improvement in the meta-analyses. CBR may improve aspects of physical fitness for older adults in Asian countries. However, variability in intervention components and measurement tools reduced the ability to pool individual studies. Further trials are required with robust designs including standardised measures of physical fitness.

Caregivers' perspectives of community acceptance before and after surgical treatment for their child's disability.

In Tanzania, about 600 000 youth between 5 and 24 years old have a disability. Individuals with disabilities face numerous obstacles due to social stigma. The aim of this formative evaluation is to assess how caregivers of children with correctable disabilities (e.g., cleft lip/palate, club foot, and burn scar contractures) in Tanzania perceive their community's acceptance of their child before and after surgical treatment. Semi-structured interviews were conducted with 80 caregivers of children with disabilities treated at Kafika House in Arusha, Tanzania. The constant comparative method identified themes regarding the caregivers' feelings on their child's functional abilities and experiences of stigma in their community. Caregiver perceptions of stigma before and after surgical treatment were categorized and quantified as 'positive', 'neutral' and 'negative'. Thematic analysis of the 80 interviews resulted in five major themes: (1) stigma and acceptance (pre-treatment) and (2) post-treatment; (3) functional abilities (pre-treatment) and (4) post-treatment; and (5) emotional impact (pre- and post-treatment). These themes indicate caregivers and their children experience a range of emotional impacts before and after treatment, more severe stigma before treatment, and overall better social, emotional and functional status after treatment. Frequency analysis of caregiver experiences indicated that stigma experienced by children and their families decreased from 75% before surgical treatment to 2.5% after surgery. Surgical intervention and rehabilitation of physical disabilities mitigated experiences of social stigma for both children and their caregivers. Findings support the need for expanded treatment of correctable disabilities, larger investments in community-based rehabilitation programmes and further interventions to support stigmatized parents and their children.

Community-based rehabilitation/community based inclusive development functioning during the COVID-19 pandemic: A secondary analysis of qualitative data.

The coronavirus (COVID-19) became a global pandemic in March 2020 and impacted nations worldwide not only because of the disease but also because the containment measures-imposed created ripple effects for the populations in each country. The COVID-19 pandemic disproportionately affected vulnerable groups, such as persons with disabilities. This study aimed to understand the impact of COVID-19 on the function of Community-Based Rehabilitation (CBR)/Community-Based Inclusive Development (CBID) across nations and for their target communities-persons with disabilities. The current article also described some measures CBR/CBID programs took in light of service closure to facilitate access to needed services for persons with disabilities. We conducted a secondary analysis of qualitative data to understand the impact of COVID-19 on the functioning of CBR/CBID programs and their target communities. The original qualitative data were collected through online dialogues among CBR/CBID partners across five regions of the world, facilitated for understanding of their practices on five other topics. COVID-19 significantly impacted the function of CBR/CBID programs across the world. Many services were halted due to public health measures, such as maintaining social distancing or lockdowns. The COVID-19 pandemic also had a negative impact on access to health, education and livelihood support for persons with disabilities. Additionally, many people with disabilities did not have access to COVID-19 related information and services like vaccines. However, we found that technology played a significant role in revitalizing CBR/CBID programs during COVID-19. CBR/CBID service providers across five regions used online platforms to disseminate information about COVID-19. Professionals also used technology to provide rehabilitation and educational services to people with disabilities through online platforms. Our findings suggest that technology can play a vital role in continuing many services (e.g., CBR/CBID) that cannot be offered in person during crises like COVID-19. However, it is important to remember that technology may not be accessible to many individuals with disabilities, specifically those who reside in rural areas and who experience adverse situations like financial constraints. Additionally, many persons with disabilities may not have the necessary knowledge and skills to use technology. CBR personnel must consider that before adopting technology to provide services under CBR programs.

Community mobility and participation assessment of manual wheelchair users: a review of current techniques and challenges.

According to the World Health Organization, hundreds of individuals commence wheelchair use daily, often due to an injury such as spinal cord injury or through a condition such as a stroke. However, manual wheelchair users typically experience reductions in individual community mobility and participation. In this review, articles from 2017 to 2023 were reviewed to identify means of measuring community mobility and participation of manual wheelchair users, factors that can impact these aspects, and current rehabilitation techniques for improving them. The selected articles document current best practices utilizing self-surveys, in-clinic assessments, and remote tracking through GPS and accelerometer data, which rehabilitation specialists can apply to track their patients' community mobility and participation accurately. Furthermore, rehabilitation methods such as wheelchair training programs, brain-computer interface triggered functional electric stimulation therapy, and community-based rehabilitation programs show potential to improve the community mobility and participation of manual wheelchair users. Recommendations were made to highlight potential avenues for future research.