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

Introduction The increasing ageing population has become a substantial challenge for both health care and social services in many Asian countries. There is a high incidence of chronic diseases and comorbidities in older populations, leading to impairments and functional disability. Functional disability may result in loss of independence, reduced quality of life and increased care needs. Community-based rehabilitation (CBR) aims to promote equality of opportunity and improve the social inclusion of individuals living with disability. CBR also provides rehabilitation to improve physical, mental, and social outcomes. However, there is limited evidence regarding the effectiveness of CBR for improving older adults’ physical fitness. The aim of this systematic review is to synthesise the evidence for the effectiveness of interventions delivered by CBR centres on physical fitness of community-dwelling older adults in Asian countries. Methods and analysis A search on four English databases (CINAHL, Medline, Scopus and Proquest) and two Chinese databases (China National Knowledge Internet and Wanfang Database) will be conducted, from inception to 15 November 2021. Both English and Chinese publications will be included. Experimental and quasi-experimental studies using any type of control group will be included. The primary outcomes are physical fitness (capacity to perform activities and tasks). Secondary outcomes are performance of activities of daily living and health-related quality of life. The quality of all included studies will be assessed using the Joanna Briggs Institute (JBI) standardised critical appraisal tools. Two reviewers will independently complete study screening, selection, quality appraisal, and data extraction. Quantitative data where possible will be pooled in statistical meta-analysis. All statistical analyses will be performed using Review Manager (Rev Man) V.5.3 software. Ethics and dissemination Ethical approval is not required for this review. The findings of this review will be disseminated electronically through a peer-reviewed publication and conference presentations. PROSPERO registration number CRD42021292088 Strengths and limitations Findings: and evidence in this review will be summarised and graded using the Grading of Recommendations, Assessment, Development and Evaluation Pro (GRADEPro) approach. A comprehensive literature search using both English and Chinese language databases will be conducted. Studies included in the review may measure different outcomes which may limit pooling in meta-analysis. Differences in populations and interventions delivered in the included studies may result in high levels of heterogeneity, leading to less certainty about the recommendations from the review.