Outcome measures for older adults in rehabilitation wards: a systematic review

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This study aimed to examine the common evaluations used in rehabilitation wards and discuss the necessary assessments for treatment plans and patient management. Methods We conducted a comprehensive literature search of PubMed, Web of Science, MEDLINE, and Ichushi Web for articles published between June 2013 and June 2023. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with PROSPERO. Data extraction and blind selection were performed, and a consensus was reached among experts in case of conflicts. Results We identified 220 studies, 31 meeting the inclusion criteria post-screening. The Functional Independence Measure was the most used assessment (96.8%), followed by grip strength (32.3%) and the 10-m walk test (9.7%). Other assessments included the Stroke Impairment Assessment Set, Short Physical Performance Battery, and Timed Up and Go Test. Although fall-related incidents are frequent, significantly affecting patient outcomes in rehabilitation units, balance assessments were underutilized. Conclusions Although the FIM is an extensively used assessment in rehabilitation wards, balance assessments critical for fall prevention are significantly underused. Therefore, these assessment tools should be evaluated in future research and clinical practice. 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F1000Research 2024, 13 :1120 ( https://doi.org/10.12688/f1000research.155302.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Systematic Review Outcome measures for older adults in rehabilitation wards: a systematic review [version 1; peer review: awaiting peer review] Shota Suzumura https://orcid.org/0000-0001-7346-9326 1,2 , Eiko Takano 3 , Toshio Teranishi 1 , [...] Kei Ito 4 , Hiroaki Sakurai 1 , Yoshikiyo Kanada 1 , Izumi Kondo 2,3 Shota Suzumura https://orcid.org/0000-0001-7346-9326 1,2 , Eiko Takano 3 , [...] Toshio Teranishi 1 , Kei Ito 4 , Hiroaki Sakurai 1 , Yoshikiyo Kanada 1 , Izumi Kondo 2,3 PUBLISHED 03 Oct 2024 Author details Author details 1 Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan 2 Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan 3 Assistive Robotics Center, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan 4 Department of Rehabilitation, Kyoto Karasuma Hospital, Kyoto, Japan Shota Suzumura Roles: Data Curation, Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Eiko Takano Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Supervision Toshio Teranishi Roles: Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Kei Ito Roles: Data Curation, Formal Analysis Hiroaki Sakurai Roles: Formal Analysis Yoshikiyo Kanada Roles: Formal Analysis Izumi Kondo Roles: Conceptualization, Methodology, Supervision OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW Abstract Purpose Detailed reports of the assessments used in rehabilitation wards are lacking. This study aimed to examine the common evaluations used in rehabilitation wards and discuss the necessary assessments for treatment plans and patient management. Methods We conducted a comprehensive literature search of PubMed, Web of Science, MEDLINE, and Ichushi Web for articles published between June 2013 and June 2023. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with PROSPERO. Data extraction and blind selection were performed, and a consensus was reached among experts in case of conflicts. Results We identified 220 studies, 31 meeting the inclusion criteria post-screening. The Functional Independence Measure was the most used assessment (96.8%), followed by grip strength (32.3%) and the 10-m walk test (9.7%). Other assessments included the Stroke Impairment Assessment Set, Short Physical Performance Battery, and Timed Up and Go Test. Although fall-related incidents are frequent, significantly affecting patient outcomes in rehabilitation units, balance assessments were underutilized. Conclusions Although the FIM is an extensively used assessment in rehabilitation wards, balance assessments critical for fall prevention are significantly underused. Therefore, these assessment tools should be evaluated in future research and clinical practice. READ ALL READ LESS Keywords outcome measures, falls, Functional Independence Measure, rehabilitation, older adults Corresponding Author(s) Eiko Takano ( [email protected] ) Close Corresponding author: Eiko Takano Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Suzumura S et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Suzumura S, Takano E, Teranishi T et al. Outcome measures for older adults in rehabilitation wards: a systematic review [version 1; peer review: awaiting peer review] . F1000Research 2024, 13 :1120 ( https://doi.org/10.12688/f1000research.155302.1 ) First published: 03 Oct 2024, 13 :1120 ( https://doi.org/10.12688/f1000research.155302.1 ) Latest published: 03 Oct 2024, 13 :1120 ( https://doi.org/10.12688/f1000research.155302.1 ) Introduction In the rehabilitation of older adults, prompt improvement in activities of daily living (ADLs) during recovery from illness or surgery is essential. ADLs include basic activities of daily living such as eating, bathing, dressing, and toileting; the ability to independently perform these activities can improve the quality of life (QOL) of older adults. ADLs are closely related to QOL 1 – 5 and social participation 6 – 9 and are fundamental in older adults leading safer and more fulfilling lives at home and in the society. In addition, this foundation helps maintain social connections, prevent isolation, and provide spiritual satisfaction. Improving ADLs requires a treatment plan that includes optimized patient management based on assessments of the patient’s physical functions and activity levels. Adequate assessment in the early stages of rehabilitation is essential to prevent safety-related adverse events, 10 which frequently occur in rehabilitation wards, and establish a foundation of independent living for older adults. After an appropriate patient assessment, an optimal treatment plan can be designed and implemented. Meanwhile, inadequate assessments and incorrect treatment plans may not only impede patient recovery but also increase the risk of safety-related adverse events in rehabilitation wards. However, detailed reports of the assessments used in rehabilitation wards are lacking. Assessment methods used in rehabilitation wards comprise physical function assessments, psychological function assessments, and assessments of social factors. Physical function assessments include muscle testing, neurological testing, and balance assessment. Moreover, cognitive and psychosocial assessments are essential for successful rehabilitation. These assessment methods are critical to the success of a rehabilitation program; therefore, evaluating their effectiveness and deriving specific remedial measures are essential. Therefore, the present study aimed to review the assessments commonly used in rehabilitation wards and discuss the assessments required for the development of treatment plans, including patient management. Through this review, we aimed to contribute to the optimization of assessments used in the rehabilitation of older adults. Methods Literature search and study selection The methodology employed in this systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 11 This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (registration number: CRD42023393290). The PRISMA checklist for this report of the review is available in Extended Dataset: Appendix 1. 12 This systematic review of the literature was conducted in July 2023. The data were collected from PubMed, Web of Science, MEDLINE, and Ichushi Web, a Japanese journal database; we reviewed articles published in the last 10 years (June 2013 to June 2023) to obtain the latest evidence. The inclusion criteria were as follows: (1) the study included patients admitted to a convalescent or rehabilitation ward; (2) the study included older adults aged 65 years or older; and (3) the paper was published in English or Japanese. Studies were excluded if they met the following criteria: (1) inclusion of a non-standard assessment; (2) wrong population such as genetic, rat, or community-dwelling older adults; (3) abstracts, letters, editorials, protocols, proceedings, expert opinions, reviews, and case reports; 4) studies of Acute, Chronic, Community-Based, and Post-Discharge Rehabilitation. Furthermore, this review focused on papers that assessed physical and daily functioning, rather than physiological, severity evaluation, nutritional, swallowing, or cognitive assessments. The search was performed using the following keywords: (“Older patients” OR “elderly patients” OR “geriatric patients” OR “senior patients” OR “aged 65 years or over” OR “65 years and older”) AND (“Rehabilitation Hospital” OR “RH ward” OR “Rehabilitation ward” OR “Rehab ward” OR “RH unit” OR “Rehabilitation unit” OR “Rehab unit”) AND (“Activity” OR “activity level” OR “activity measures” OR “functional activity”) ( Table 1 ). Table 1. Keywords used for the search strategy. 1 “Older patients” OR “elderly patients” OR “geriatric patients” OR “senior patients” OR “aged 65 years or over” OR “65 years and older” 2 “Rehabilitation Hospital” OR “RH ward” OR “Rehabilitation ward” OR “Rehab ward” OR “RH unit” OR “Rehabilitation unit” OR “Rehab unit” 3 1 AND 2 4 “Activity” OR “activity level” OR “activity measures” OR “functional activity” 5 3 AND 4 All references from the initial search were exported to Rayyan software for data extraction. After the removal of duplicates, the first and second authors of the present study performed a blinded selection of literature according to the inclusion and exclusion criteria. The initial screening was based on the titles and abstracts of the identified articles. Subsequently, the same experts evaluated the full text of selected papers. In the case of conflicting opinions, a consensus was reached through discussion among the three experts. Results The initial comprehensive search of PubMed, Web of Science, MEDLINE, and Ichushi Web databases produced 220 articles. After the removal of duplicate articles, 206 articles were selected. A thorough screening of the titles and abstracts led to the exclusion of 169 articles. Afterward, the full texts of the remaining 37 articles underwent a meticulous review. Ultimately, after thorough analysis, 31 articles were deemed appropriate for data extraction and, 13 – 43 thus, included in the review (Extended Dataset: appendix 2). 12 The detailed results of the review are shown in Tables 2 and 3 . The Functional Independence Measure (FIM) was the most frequently used outcome measure for inpatients in the rehabilitation ward (n = 30, 96.8%). 13 – 42 The FIM is a widely used tool for evaluating ADLs. 44 Other commonly used evaluations in rehabilitation wards include grip strength (n = 10, 32.3%), 27 , 13 , 16 , 18 , 19 , 22 , 23 , 29 , 41 , 43 the 10-meter walk test (10MWT; n = 3, 9.7%), 16 , 29 , 41 the Stroke Impairment Assessment Set (SIAS; n = 2, 6.5%), 26 , 38 the Short Physical Performance Battery Test (SPPB; n = 2, 6.5%), 29 , 43 the Brunnstrom stage test (BRS-t; n = 1, 3.2%), 19 the Functional Ambulation Categories (FAC; n = 1, 3.2%), 24 the 30-second chair stand test (CS-30; n = 1, 3.2%), 16 the Katz Index of Independence in Activities of Daily Living (Katz Index of Independence in ADL, n = 1, 3.2%), 43 the Lawton Instrumental Activities of Daily Living scale (Lawton IADL scale; n = 1, 3.2%), 43 the Timed Up and Go Test (TUG; n = 1, 3.2%), 43 and the Frail 10-second Chair Stand Test for Frail Elderly (Frail CS-10; n = 1, 3.2%). 42 Table 2. Descriptive analyses of the 31 studies included in the present review. Author Specific objective Year Participants Setting Evaluation Abe et al. 12 To assess the nutritional status of patients in the recovery ward and examine the characteristics of undernourished patients 2020 94 older adult patients aged 65 years or older Rehabilitation ward • FIM • Grip strength Aoki et al. 13 To identify factors influencing the discharge destination of stroke patients in the rehabilitation ward 2019 103 older adult patients with stroke aged 65 years or older Rehabilitation ward • FIM Brown et al. 14 To investigate the association between the number of days of hospitalization from the onset of stroke to admission in the rehabilitation ward, nutritional status, and ADL recovery in patients with stroke 2021 89 older adult patients with stroke aged 65 years or older Rehabilitation ward • FIM Fujii et al. 15 To examine whether BCAA-fortified dietary supplements are effective in improving ADLs and the rehabilitative effects may be expected 2019 14 older adult patients with stroke aged 65 years or older (the intervention or control group) Rehabilitation ward • FIM • 10MWT • CS-30 • Grip strength Hanaoka et al. 16 To investigate the relationship between H 2 RA use and FIM gain, which determines the rehabilitation outcomes for patients admitted to rehabilitation wards 2020 236 older adult patients aged 65 years or older [H 2 RA (-), H 2 RA (+) group] Rehabilitation ward • FIM Iwase et al. 17 To identify factors associated with home discharge in older adult patients with femoral fractures 2017 66 older adult patients aged 85 years or older with a femoral fracture (discharged home or to a non-home group) Rehabilitation ward • FIM • Grip strength Kameyama et al. 18 To determine whether sarcopenia affects ADLs in older adult patients with stroke 2022 283 older adult patients with stroke aged 65 years or older Rehabilitation ward • FIM • Grip strength • BRS-t Kose et al. 19 To examine the effect of PIM on rehabilitation outcomes in geriatric patients after stroke 2018 272 older adult patients with stroke aged 65 years or older Rehabilitation ward • FIM Kose et al. 20 To examine the effect of deprescribing from polypharmacy on ADL recovery and home discharge by rehabilitation in older patients with sarcopenia after stroke 2023 153 older adult patients aged 65 years or older diagnosed with sarcopenia with polypharmacy Rehabilitation ward • FIM Kubo et al. 21 To identify factors associated with ADL ability in older adult orthopedic patients with comorbid cognitive impairment and depression 2021 104 older adult patients aged 65 years or older with orthopedic diseases (no cognitive impairment and no depression, no cognitive impairment and depression, cognitive impairment and no depression, cognitive impairment, and depression groups) Rehabilitation ward • FIM • Grip strength Matsumoto et al. 22 To investigate the association between polypharmacy at hospital discharge and nutritional intake, muscle strength, and ADLs among older patients undergoing rehabilitation after stroke 2022 179 older adult patients with stroke aged 65 years or older Rehabilitation ward • FIM • Grip strength Miura et al. 23 To assess ADLs and the gait ability of patients with a PFF who had frailty before hospital admission 2021 12 older adult patients aged 65 years or older (frail and no frail groups) Rehabilitation ward • FIM • FAC Mizurahi et al. 24 To investigate whether, and to what extent, post-stroke eating management at admission to a rehabilitation ward is associated with functional outcome. 2013 716 older adult patients with stroke aged 65 years or older. Rehabilitation ward • FIM Murakami et al. 25 To investigate the relationship between improvement in ADLs and discharge to home among older stroke patients in a rehabilitation ward 2020 291 older adult patients aged 65 years or older with cerebral infarction (early-stage or late-stage older adult groups) Rehabilitation ward • FIM • SIAS Nagao et al. 26 To investigate the prevalence of sarcopenia in patients with proximal femoral fractures who underwent surgery 2018 134 older adult patients aged 65 years or older with femoral fractures (sarcopenia or non-sarcopenia group) Rehabilitation ward • FIM • Grip strength Nakamura. 27 To clarify risk factors for aspiration pneumonia and the effects of aspiration pneumonia on recovery after stroke in older adult patients with stroke in a rehabilitation ward. 2020 463 older adult patients with stroke aged 65 years or older who have dysphagia Rehabilitation ward • FIM Ohtsubo et al. 28 To assess the association of sarcopenia and physical activity with functional outcomes in older hospitalized rehabilitation patients 2022 211 older adult patients aged 65 years or older with musculoskeletal and neurological diseases Rehabilitation ward • FIM • SPPB • 10MWT • Grip strength Otsubo et al. 29 To examine the relationship between cognitive dysfunction affecting motor FIM and hypnotics 2022 509 older adult patients aged 65 years or older with stroke, orthopedic disease, or disuse syndrome Rehabilitation ward • FIM Sato 30 To identify predictive factors of home discharge in older adult patients with stroke hospitalized in our rehabilitation ward based on markers determined during hospitalization and to evaluate their predictive capability 2020 179 older adult patients with stroke aged 65 years or older Rehabilitation ward • FIM Sato et al. 31 To investigate the factors associated with undernutrition during admission in patients with cerebral infarction 2022 220 older adult patients with stroke aged 65 years or older Rehabilitation ward • FIM Sato et al. 32 To examine the association between undernutrition and performance index in patients with stroke 2020 108 older adult patients with stroke aged 65 years or older Rehabilitation ward • FIM Sato et al. 33 To investigate the association between the area of the psoas major muscle and prognosis in patients with cerebral infarction 2019 55 older adult patients with stroke aged 65 years or older Rehabilitation ward • FIM Shimizu et al. 34 To determine the relationship between inadequate energy intake and change in physical activity at the start of recovery rehabilitation in hospitalized patients 2022 42 older adult patients aged 65 years or older with orthopedic diseases Rehabilitation ward • FIM Shirosaki et al. 35 To examine the relationship between nutritional management and rehabilitation effectiveness in a rehabilitation ward 2017 52 older adult patients aged 65 years or older Rehabilitation ward • FIM Takei et al. 36 To clarify the influence of cognitive function on ADL and improvement of ADL at admission and discharge in patients with late-onset musculoskeletal disease based on severity of illness 2021 51 older adult patients aged 75 years or older with orthopedic diseases (cognitive function: normal, mildly impaired, moderately impaired, and severely impaired groups) Rehabilitation ward • FIM Takeuchi et al. 37 To examine the effect of early rehabilitation on patients with stroke based on FIM severity at admission 2017 312 older adult patients with stroke aged 65 years or older Rehabilitation ward • FIM • SIAS Tokunaga et al. 38 To clarify the relationship between improvement in the GNRI and improvement in the FIM 2016 155 older adult patients with stroke aged 65 years or older Rehabilitation ward • FIM Umemoto et al. 39 To identify factors associated with the improved FIM scores from admission to discharge in TKA patients 2022 25 older adult patients aged 65 years or older who underwent post-operative TKA (FIM improvement <12 points group or FIM improvement ≥12 points group) Rehabilitation ward • FIM Watanabe et al. 40 To investigate the rate of sarcopenia in a rehabilitation ward 2018 29 older adult patients aged 65 years or older with orthopedic disease (sarcopenia group or non-sarcopenia group) Rehabilitation ward • FIM • 10MWT • Grip strength Yagi et al. 41 To clarify the impact of sarcopenia on the performance index of patients admitted to rehabilitation wards 2022 128 older adult patients aged 65 years or older with stroke, musculoskeletal disorder, or disuse syndrome Rehabilitation ward • FIM • Frail chair standard-10 Zasadzka et al. 42 To analyze the impact of inpatient rehabilitation on the functional status of the older adults 2016 100 older adult patients aged 65 years or older Rehabilitation ward • Katz Index of Independent in ADL • Lawton IADL scale • TUG • SPPB • Grip strength Table 3. Outcome measures for older adults in rehabilitation wards. Evaluation scales Number of articles FIM 30 Grip strength 10 10MWT 3 SIAS 2 SPPB 2 BRS-t 1 FAC 1 CS-30 1 Katz Index of Independent in ADL 1 Lawton IADL scale 1 TUG 1 Frail CS-10 1 Extended Dataset: Appendix 3 12 , 81 – 117 presents commonly used evaluations for older adults in rehabilitation wards, along with information on their reliability and validity (construct validity and criterion-related validity). These evaluations include the FIM 45 and Katz Index of Independent in ADL 46 for ADL evaluation; the Lawton IADL Scale 47 for IADL evaluation; the 10MWT, 48 FAC, 49 and TUG 50 for the assessment of walking ability; grip strength, the CS-30, 51 and the Frail CS-10 52 for muscle strength evaluation; the SIAS 53 , 54 for the assessment of the degree of paralysis; and the SPPB 55 for the assessment of physical function. Evaluation of ADLs and IADL The FIM 45 and Katz Index of Independent in ADL 46 are foundational in assessing ADLs such as dressing, bathing, and eating. These tools are highly reliable and possess a strong construct validity, demonstrating their effectiveness in reflecting patients’ functional status. Similarly, the Lawton IADL Scale 47 extends this assessment to more complex daily activities, including financial management and medication use, which are critical for independent living. Evaluation of muscle strength Grip strength is a targeted measure of muscle strength, which is a predictor of morbidity and mortality in older adults. In addition, the CS-30 51 and Frail CS-10 52 are simple but powerful predictors of overall health and functional decline; these tests are used in the evaluation of muscle strength. Assessment of walking ability The 10MWT 48 measures walking speed over a short distance and is a quick indicator of mobility limitations. The FAC 49 assesses the level of support required by a patient for walking, which is crucial for safety and independence. The TUG, 50 combining the elements of balance, speed, and agility, is particularly valuable for predicting fall risk. These assessments help in developing individualized rehabilitation programs that improve mobility and reduce fall risk. Assessment of paralysis and physical function The SIAS 53 , 54 and BRS-t 56 , 57 provide a detailed measure of paralysis and are particularly useful in stroke rehabilitation. The SPPB 55 is a comprehensive tool that assesses lower extremity function and is a predictive index of disability. It combines balance, gait ability, and strength evaluation. Discussion We conducted a systematic review of commonly used assessments in rehabilitation wards. The results showed that the FIM was the most frequently used assessment method, appearing in 30 (96.8%) of the 31 articles reviewed. Grip strength assessment was used in 10 articles (32.3%), and the 10MWT was mentioned in three articles (9.7%). These assessments are essential for developing an appropriate treatment plan for each patient. Assessment plays an important role in rehabilitation treatment planning and in determining the effectiveness of interventions. Kirshner et al. 58 categorized assessments into discriminative, predictive, and evaluative measures according to their specific use. Discriminative measures are used to determine the presence or absence of a disease, and predictive measures are used to predict treatment outcomes. Meanwhile, evaluative measures are used to assess an intervention’s effectiveness and for the adjustment of the treatment plan, as necessary. In rehabilitation, these outcome measures are used to identify specific problems, determine the effectiveness of interventions, assess risks, and determine a patient’s range of behavior. Thus, assessment in rehabilitation plays a multifaceted role and significantly contributes to patient recovery and QOL. In rehabilitation wards, efforts focus on improving patients’ functions and abilities, thus extending the range of ADL, and establishing an appropriate range of activities for patients. Several studies have shown a positive association between physical activity levels and QOL. A systematic review found that higher physical activity levels were associated with better QOL across different populations, including older adults and those with clinical conditions. 59 , 60 Meanwhile, an increased range of activities increases the risk of falls. 61 , 62 Therefore, it is important to reduce the risk of falls, which are common in rehabilitation wards. 10 Reported fall rates among hospitalized patients range from 1% to 17%. 63 – 67 In particular, 36–73% of patients with stroke experience falls within 6 months of discharge, 68 – 72 with 61% occurring in the first 2 months after discharge. 73 Furthermore, falls are associated with the fear of falling, anxiety, and reduced ADLs; appropriate fall-related assessments are needed to reduce the risk of falls. 74 – 77 However, our review revealed that balance assessment indices are rarely used in the evaluation of fall risks. Only two of the 31 articles (6.5%) used the SPPB, which includes balance assessment, and the TUG test was utilized in one article (3.2%). According to Ganz et al., a history of falls and abnormalities in gait and balance are significantly associated with the occurrence of falls. Conversely, visual impairment, administered drugs, reduced ADLs, and cognitive impairment are not good predictors of falls. 78 Teranishi et al. reported a close association between static standing balance ability and falls, underscoring the importance of balance assessment for fall prevention. 79 When the ability for ADLs reaches a plateau, training can improve balance ability. 80 Therefore, balance assessments, in addition to ADL assessments, should be performed regularly and frequently; if otherwise, it will be challenging to prevent falls after a discharge from the hospital. Although preventing all fall events is difficult, the risk can be minimized via thorough assessment and intervention. This study’s significant strength is that it provides the first comprehensive analysis of outcome measures widely used in rehabilitation wards. However, the study has several limitations. First, the literature reviewed was limited to English and Japanese, meaning essential studies in other languages may not have been included. Second, we only included studies on the outcome measures for patients in rehabilitation wards; therefore, data on the assessment methods used in other wards (e.g., acute or chronic) were not considered. Third, the present study lacks data to directly compare the effectiveness and efficacy of the assessment instruments. Therefore, future studies review a more diverse literature and examine the use of assessment tools in different healthcare settings. This study systematically reviewed the status of assessment methods used in rehabilitation wards and confirmed that the FIM is the most widely used measure, particularly in rehabilitation settings. However, the use of critical assessment measures, such as balance assessments, was inadequate in the crucial aspect of fall prevention. Therefore, the active use of these assessment tools and verification of their effectiveness are required in future research and clinical practice. The results of the present study may contribute to further improving the quality of rehabilitation. Author contributions ET and IK: study concept and design. SS, ET, KI: acquisition of data (literature search and study selection). SS, ET, TT, HS, YK, and KI: analysis and interpretation of data (literature). SS, TT: writing—original draft preparation. ET, IK: supervision. SS, TT: writing—review and editing. All authors contributed to the article and approved the submitted version. Data availability statement Underlying data Figshare. Outcome measures for older adults in rehabilitation wards: A systematic review. https://doi.org/10.6084/m9.figshare.26838841.v2 118 This study contains the following underlying data in the extended dataset: • Data file Appendix 1. PRISMA checklist • Data file Appendix 2. Flowchart of the search strategy • Data file Appendix 3. The evaluations used for older adult in rehabilitation wards Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). References 1. Zurek G, Lepsy E, Zurek A, et al. : The relationship between the level of physical activity, independence in daily activities, and life quality and satisfaction in women over 80 living in rural areas - a pilot study. Rocz. Panstw. Zakl. Hig. 2020; 71 (2): 171–180. PubMed Abstract | Publisher Full Text 2. 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Suzumura S, Takano E, Teranishi T, et al. : Outcome measures for older adults in rehabilitation wards: A systematic review. figshare. [Dataset]. 2024. Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 03 Oct 2024 ADD YOUR COMMENT Comment Author details Author details 1 Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan 2 Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan 3 Assistive Robotics Center, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan 4 Department of Rehabilitation, Kyoto Karasuma Hospital, Kyoto, Japan Shota Suzumura Roles: Data Curation, Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Eiko Takano Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Supervision Toshio Teranishi Roles: Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Kei Ito Roles: Data Curation, Formal Analysis Hiroaki Sakurai Roles: Formal Analysis Yoshikiyo Kanada Roles: Formal Analysis Izumi Kondo Roles: Conceptualization, Methodology, Supervision Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 03 Oct 2024, 13:1120 https://doi.org/10.12688/f1000research.155302.1 Copyright © 2024 Suzumura S et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Suzumura S, Takano E, Teranishi T et al. Outcome measures for older adults in rehabilitation wards: a systematic review [version 1; peer review: awaiting peer review] . 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