Effectiveness Of Community-based Rehabilitation Research Articles

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.

Effectiveness of community-based rehabilitation (CBR) centres for improving physical fitness for community-dwelling older adults: a systematic review protocol

IntroductionThe increasing ageing population has become a substantial challenge for both healthcare and social services in many Asian countries. There is a high incidence of chronic diseases and comorbidities in...

Content and Effectiveness of Community-Based Rehabilitation on Quality of Life in People Post Stroke: a Systematic Review with Meta-Analysis

Disability, CBR and Inclusive Development aims to enhance knowledge in the field of disability and inclusive development, addressing the needs of practitioners, policy makers, DPOs and the scientific community.

Content and effectiveness of community-based rehabilitation on quality of life in people post-stroke: A systematic review with meta-analysis

Background and Aims : Community based rehabilitation (CBR) aims to provide rehabilitative services to people with disabilities in their home or community. It was as an affordable way of offering rehabilitation to children with disabilities in the rural areas. After its adoption in 1978, it developed into more towards social inclusion of people with disability. Aims: To review the content and evaluate the effects of CBR on quality of life (QoL), balance, and walking capacity for people post-stroke compared to other rehabilitation protocols or no care.

Effectiveness of Community-Based Rehabilitation on the lives of Parents of Children with Cerebral Palsy: A Mixed Method Study in Karnataka, India

Purpose: The study aimed to identify the effects of the CBR programme on parents of children with Cerebral Palsy, living in Karnataka State, India. It also tried to find the challenges and improvements needed to make the CBR programme more effective. Method: A cross-sectional, descriptive study design was used to collect a sample of 100 parents of children with Cerebral Palsy, with GMFCS levels IV and V. The sample was drawn from various communities in Bangalore, Davanagere and Bijapur, where the services of The Association of People with Disability are available. Face-to-face interviews were conducted with the study subjects. Data was analysed by SPSS using descriptive and inferential statistics. Results: It was observed that the CBR programme had a positive effect on parents’ health, knowledge, social lives and empowerment. A binary logistic regression was done to find the relationship between health, knowledge, social lives and assistive devices use. A strong association was found between all the areas (p=.001) except GMFCS and assistive devices use (p=.004) at 95% CI. The odds ratios between them were greater than 1 and showed the strong positive effect of the CBR programme on parents. Conclusion: The CBR programme not only has a positive effect on children with Cerebral Palsy, but also plays an important role in parents’ lives. It contributes in a positive way to parents’ overall activity.

Effects of Community-based Rehabilitation Programs on Activities of Daily Living, Quality of Life and Assistive Technology Satisfaction for Disabled Adults in South Korea

The purpose of this study was to examine the effects of communitybased rehabilitation (CBR) program on activities of daily livings (ADLs), quality of life and assistive technology satisfaction for disabled adults in South Korea. Fourteen community-dwelling subjects were participated in a home-based rehabilitation program which performed once a month for 2 months. The outcome measures included Modified Barthel Index (MBI) for assessing ADLs, EuroQol five-dimensions questionnaire (EQ- 5D) for quality of life (QoL) and Quebec User Evaluation of Satisfaction with assistive Technology 2.0 (QUEST 2.0) for assistive technology. Significant improvements in ADLs, quality of life and assistive technology satisfaction were observed after the program. This study indicated that community-based rehabilitation program is an effective method for improving ADLs, quality of life and assistive technology satisfaction for adults with disabilities.

Do community-based rehabilitation programmes promote the participation of persons with disabilities? A case control study from Mandya District, in India

Purpose: In this paper, we measure the effectiveness of Community-Based Rehabilitation (CBR) programmes in promoting the well-being of people with disabilities and removing the barriers to their participation in family and community decision-making processes. Method: To evaluate the impact of the CBR programme, we use data from a large-scale control study in Karnataka, India. Propensity score matching is used to evaluate the impacts on disabled persons after 2, 4 and 7 years of entering the CBR. The theoretical framework for the analysis is based on the CBR guidelines, which are combined with the International Classification of Functionings (ICF), the United Nations Convention on the Rights of People with Disabilities (UN CRPD) and Amartya Sen’s capability approach. Results: CBR has a positive impact on the well-being of persons with disabilities participating in the programme and particularly on their participation within the family and the society at large. Conclusions: CBR programmes have a multidimensional and positive impact on individual and collective capabilities; on individual, agency and social empowerment.Implications for RehabilitationCommunity-Based Rehabilitation (CBR) can make a lasting difference in the life of persons with disabilities.CBR improves participation and inclusion of persons with disabilities in the family and in the community.

Effectiveness of Community-Based Rehabilitation After Traumatic Brain Injury for 489 Program Completers Compared With Those Precipitously Discharged

Altman IM, Swick S, Parrot D, Malec JF. Effectiveness of community-based rehabilitation after traumatic brain injury for 489 program completers compared with those precipitously discharged. Objective To evaluate outcomes of home- and community-based postacute brain injury rehabilitation (PABIR). Design Retrospective analysis of program evaluation data for treatment completers and noncompleters. Setting Home- and community-based PABIR conducted in 7 geographically distinct U.S. cities. Participants Patients (N=489) with traumatic brain injury who completed the prescribed course of rehabilitation (completed-course-of-treatment [CCT] group) compared with 114 who were discharged precipitously before program completion (precipitous-discharge [PD] group). Intervention PABIR delivered in home and community settings by certified professional staff on an individualized basis. Main Outcome Measures Mayo-Portland Adaptability Inventory (MPAI-4) completed by means of professional consensus on admission and at discharge; MPAI-4 Participation Index at 3- and 12-month follow-up through telephone contact. Results Analysis of covariance (CCT vs PD group as between-subjects variable, admission MPAI-4 score as covariate) showed significant differences between groups at discharge on the full MPAI-4 (F=82.25; P<.001), Ability Index (F=50.24; P<.001), Adjustment Index (F=81.20; P<.001), and Participation Index (F=59.48; P<.001). A large portion of the sample was lost to follow-up; however, available data showed that group differences remained statistically significant at follow-up. Conclusions Results provided evidence of the effectiveness of home- and community-based PABIR and that treatment effects were maintained at follow-up.

Poster 3: Effectiveness of Community-Based Rehabilitation After Traumatic Brain Injury for 489 Program Completers Compared to Those Precipitously Discharged

Objective: To evaluate outcomes of home- and community-based postacute brain injury rehabilitation. Design: Retrospective analysis of program evaluation data for treatment completers and noncompleters. Setting: Home- and community-based postacute brain injury rehabilitation conducted in 7 geographically distinct U.S. cities. Participants: 489 individuals with traumatic brain injury who completed the prescribed course of rehabilitation (CR) compared to 114 who were precipitously discharged prior to program completion (PD). Interventions: Postacute brain injury rehabilitation delivered in home- and community-settings by certified professional staff on an individualized basis. Main Outcome Measures: Mayo-Portland Adaptability Inventory (MPAI-4) completed by professional consensus on admission and at discharge; MPAI-4 Participation Index at 3- and 12-month follow-up through telephone contact. Results: Analysis of covariance (CR vs PD = between-subjects variable; admission MPAI-4 score = covariate) showed significant differences between groups at discharge on the full MPAI-4 (F=82.25, P<.0001), Abilities Index (F=50.24, P<.0001), Adjustment Index (F=81.20, P<.0001), and Participation Index (F=59.48, P<.0001). A large portion of the sample was lost to follow-up; however, available data showed group differences remained statistically significant at follow-up. Conclusions: Results provide evidence of the effectiveness of home- and community-based postacute brain injury rehabilitation and that treatment effects are maintained at follow-up.