Activity card sort and the occupational repertoire of older adults: an integrative literature review

Bernardo, Lilian Dias; Pontes, Tatiana Barcelos; Souza, Klysna Imbroinisio de; Ferreira, Rafaela Guilherme; Deodoro, Tainá Maria Silva; Almeida, Pedro Henrique Tavares Queiroz de

doi:10.1590/2526-8910.ctoAR2130

person Lilian Dias Bernardo

schoolInstituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro – IFRJ, Rio de Janeiro, RJ, Brasil.

0000-0001-5234-4225

person Tatiana Barcelos Pontes

schoolBoston University Sargent College of Health & Rehabilitation Sciences, Boston, Massachusetts.

0000-0002-1870-7157

person Klysna Imbroinisio de Souza

schoolInstituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro – IFRJ, Rio de Janeiro, RJ, Brasil.

0000-0002-9397-7747

person Rafaela Guilherme Ferreira

schoolInstituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro – IFRJ, Rio de Janeiro, RJ, Brasil.

0000-0002-0843-3965

person Tainá Maria Silva Deodoro

schoolInstituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro – IFRJ, Rio de Janeiro, RJ, Brasil.

0000-0003-0469-3994

person Pedro Henrique Tavares Queiroz de Almeida

schoolBoston University Sargent College of Health & Rehabilitation Sciences, Boston, Massachusetts.schoolUniversity of Western Ontario, London, Canadá.

0000-0002-1656-6899

Lilian Dias Bernardo participated in all the stages of writing the article: text design, organization of sources and/or analysis, writing, and review of the text. Tatiana Barcelos Pontes and Pedro Henrique Tavares Queiroz de Almeida participated in data analysis, manuscript writing, and review. Klysna Imbroinisio de Souza, Rafaela Guilherme Ferreira, and Tainá Maria Silva Deodoro participated in the data collection and the writing of the article. All authors approved the final version of the text.

Corresponding author Lilian Dias Bernardo e-mail:
lilian.bernardo@ifrj.edu.br

Section editor Iza Faria-Fortini

Authors and year	Context	Outcome
Chan et al. (2006)	Transcultural Adaptation	ACS-Hong Kong consists of 65 activities. Four cultural activities were included.
Packer et al. (2008)		ACS-Australia consists of 82 activities, divided into domestic, social/educational, and leisure activities.
Laver-Fawcett & Mallinson (2013)		ACS-UK consists of 91 activities. The response variable “do more” was inserted.
Uemura et al. (2018)		ACS-Japan consists of 72 activities. Eight cultural activities were included.
Alegre-Muelas et al. (2019)		ACS-Japan consists of 72 activities. Eight cultural activities were included.
Alegre-Muelas et al. (2019)		ACS-Spain consists of 79 activities and insertion of the social participation and productivity and education domains. Three cultural activities were included.
Sachs & Josman (2003)	Utility	ACS-Israel, ACS-United Kingdom, ACS-Holland: Intelligent and had good acceptance and clinical utility by the older adults.
Eriksson et al. (2011)
Laver-Fawcett et al. (2016)
Poerbodipoero et al. (2016)
Jong et al. (2012)	Inter and intra-examiner agreement	High level of inter and intra-examiner agreement.
Katz et al. (2003)	Reliability, Internal Consistency, and Validity	Good test-retest reliability, internal consistency, convergent validity with quality of life instruments for post-stroke patients, or for multiple sclerosis or with functional status instruments. Except for the study by Poerbodipoero et al., that the convergent validity was weak to moderate.
Chan et al. (2006)		Good apparent validity and discriminative validity between healthy adults/older adults, post-stroke and Alzheimer's; different age groups; among healthy and with multiple sclerosis older adults.
Doney & Packer (2008)
Lyons et al. (2010)
Orellano et al. (2012)
Hamed & Holm (2013)
Poerbodipoero et al. (2016)
Laver-Fawcett et al. (2016)

Authors and year	Context	Outcomes
	Level of participation in:
Hartman-Maeir et al. (2007a)	Post-stroke individuals	The stroke had a serious and lasting impact on the level of participation.
Spitzer et al. (2011)	With/without cognitive impairment	When in the younger age group, reduced social activities, and leisure of high/low demand. Older people even gave up on IADLs.
Wolf et al. (2012)	With/without somatosensory impairment	Those with cognitive deficits reduced the high demand for leisure and social/educational activities.
Tse et al. (2017, 2018)		The presence of paresis in the members and the sensory impairments reduced the level of participation in all domains of the ACS.
Carey et al. (2018)		At follow-up, without the presence of depression, the preservation of activities was resumed, especially social and leisure activities.
Verberne et al. (2019)
Cipriani et al. (2006)	Older adults	Elderly people with activity limitations or cognitive, sensory (except auditory) and mood deficiencies, and the presence of neurodegenerative disease showed significant reductions in participation levels.
Albert et al. (2009)	With/without limitations in ADL and IADL.	High-demand leisure activities and social activities were the most affected among those who had a health condition, with the retired, vulnerable, those who lived alone or took care of their grandchildren.
Perlmutter et al. (2010)	With/without sensory, cognitive, and/or mood deficiency	For institutionalized elderly people, the level of participation in IADL was reduced by the routine of the establishments, as the activities were carried out by third parties. The same occurred for vulnerable elderly people, but due to lack of opportunity or interest. IADLs were the most required by older adults with cognitive deficits for reengagement, as it was associated with the independence to live alone.
Duncan & Earhart (2011)	Mild cognitive impairment (CCL)	Age, for retirees, interfered negatively in participation.
Lyons et al. (2011, 2013)	Parkinson's disease (PD)	Male retirees had higher participation in activities than women. The same was observed in transplant recipients.
Orellano et al. (2014)	Hip fracture	For healthy elderly people, the most significant activities were chosen by culture.
Lee (2014)	Cancer	The elderly with fractures recovered low-demand leisure activities up to 6 months after the injury.
Marken & Howard (2014)	Stem cell transplants
Chapman & Nelson (2014)	Vulnerable
Fox et al. (2017)	Institutionalized
Rodakowski et al. (2018)	Healthy, community residents
Segev-Jacubovski et al. (2018)	Retired
	Take care of grandchildren
Kniepmann (2012, 2014)	Caregivers	There was a reduction in participation after taking on the role of caregivers.
Kniepmann & Cupler (2014)	Post-stroke older adults	The greater the social support, the greater the level of participation.
Rosenwax et al. (2014)	Who became widows	Social, educational and leisure activities were the ones that suffered the most reduction.
	Correlation between participation and:
Hartman-Maeir et al. (2003)	Disease awareness in post-stroke older adults	The lower the awareness, the longer hospitalized and the lower level of participation.
Hartman-Maeir et al. (2007b)	Post-stroke satisfaction and emotional status	There was a negative correlation between satisfaction and depression at the level of participation.
Spitzer et al. (2011)	Post-stroke cognition and mood	Mild cognitive impairment was associated with a lower level of participation.
Jung et al. (2015)	Fear of falling among the older adults	Moderate positive correlations between confidence in not falling and participation in IADL, social, and leisure activities.
Engel-Yeger & Rosenblum (2017)	Sensory processing in the community	Lower sensory processing skills correlated with a lower level of participation in IADL, low/high demand social and leisure activities.
Shpigelman et al. (2017)	Quality of life of elderly people with memory complaints	Older adults with cognitive complaints had less participation and quality of life. Depression and level of participation were predictors of quality of life.
Seaton & Brown (2018)	With body functions and structures in the older adults	Association between manual dexterity and levels of participation. Mobility, balance, and coordination did not impact their participation.
Hanna et al. (2019)	Sitting time and fear of falling in post-stroke elderly people with/without upper limb deficit.	It reduced, on average, 20% of post-stroke activities. The longer sitting or deficits in the upper limb, the less participation in activities that involved standing or walking.
Tse et al. (2017)	Humor	Each depressive symptom was associated with a 1% decrease in the level of participation.
	Factors that interfere with participation in:
Tucker et al. (2012)	Post-stroke individuals (without and with aphasia)	Self-perception of post-stroke functional recovery and subjective well-being of caregivers were predictors of participation.
Wolf & Koster (2013)	Widowed caregivers	The lack of opportunity, interest, company, or the demand for physical effort were factors that reduced the participation of vulnerable elderly people.
Rosenwax et al. (2014)	Women living alone
Fox et al. (2017)	Vulnerable older adults

Authors and year	Context:	Target Audience:	Outcomes
	Intervention	Indivíduals with
		Nº of participants (N)
		Groups (G)
Hartman-Maeir et al. (2007a)	Community rehabilitation (CR)	Post-stroke	G1 and G2 had a low functional level, with assistance for ADL and IADL (exception: “use of the phone” in G1). G1 showed a significant improvement (± 15%) in the level of participation and satisfaction with life than the control group (G2).
		N: 83
		G1: 27 CR
		G2: 56 without CR
Packer et al. (2009)	Vision Self-management Programme (VSM)	Visual impairment	In the post-intervention, there was a statistically significant increase in participation (8%) and a reduction in depressive symptoms. At follow-up (12 weeks after the end of the intervention), the level was 1% above the pre-intervention.
		N: 13
		Intervention group only
Girdler et al. (2010)		N:36	G1 increased the level of participation compared to G2, regardless of depressive symptoms.
		G1: usual care +VSM
		G2: usual care
Ghahari et al. (2010)	Online fatigue self-management program (“Managing Fatigue” - MF)	Extreme fatigue	G1 and G2 increased participation. G1 showed better results than G3, mainly in self-efficacy.
	Online or in-person	N: 115	There were no significant differences between the three groups for fatigue, quality of life, depression, anxiety, stress, or social support.
		G1: MF online
		G2: MF no activities and interaction
		G3: group control
Ghahari & Packer (2012)		N:115	G2 obtained a better score than G1 for reducing overall fatigue, except for follow-up, which resulted in a higher level of participation.
		G1: online	G1 and G2 had improvement in general and cognitive fatigue than G3, after the intervention and at follow-up. G1 had better self-management of depression, stress, and self-efficacy.
		G2: in person
		G3: control
		G4: without intervention.
Henshaw et al. (2011)	Cognitive Orientation to Daily Occupational Performance (CO-OP)	Post-AVE	Case 1 increased in participation and case 2 maintained the participation, without knowing whether it was statistically significant.
		N:2
		Intervention group only
Foster et al. (2013)	Community tango dance program	Parkinson	G1 participation increased to 90% and G2 remained around 80%. Low demand leisure with more consistent improvements in G1.
		N:52
		G1: tango
		G2: control
Wehofer et al. (2013)	Use of activities and Equine-assisted therapy	Risk of falling	There was an increase in 12 activities after the intervention with hippotherapy, with reduction of chronic pain, improvement in functional balance, decreasing the risk of falling.
		N: 1
		G: Not applicable
Sturkenboom et al. (2014)	Occupational therapy at home	Parkinson	G1 increased participation in IADL compared to G2, 3 and 6 months after the intervention, greater satisfaction with performance in activities, perception, and coping with daily functioning.
		N:191
		G1: 124 with OT
		G2:67 control, without OT.
Sabari et al. (2015)	Brooklyn Parkinson's Group Community Program (BPg)	Parkinson	G1 preserved activities more, especially for low-demand and social leisure. No difference between groups in quality of life.
		N: 26
		G1: 13 with BPg
		G2: 13 without BPg
McNamara et al. (2016)	Community program	Weakness	Positive effect on the level of participation, particularly for IADL and leisure. Participants were more confident.
		N: 21
		Intervention group only
Kaizerman-Dinerman et al. (2018)	Metacognitive group intervention (MCG)	Schizophrenia	Significant increases in performance, activity, and participation in G1, mainly in IADL.
		N: 84
		G1: 43 MCG
Kaizerman-Dinerman et al. (2019)		G2: 41 control	G1 used more cognitive strategies (secret and open) and predicted participation.
Wetherell et al. (2018)	Activity, Balance, Learning, and Exposure (ABLE)	Fear of falling	G1 showed a significant reduction in fear of falling and increased participation. No differences in drop rates between groups, intervention, and follow-up.
		N: 42
		G1: 21 ABLE
		G2: 21 preventive guidelines.
Kim & Cho (2018)	Occupational-centered cognitive rehabilitation	MCI	AIVD increased but was not significant. The intervention improved cognitive skills.
		N: 6
		Intervention group only
Gould et al. (2018)	Breathing, Relaxation, Education for Anxiety Treatment in the Home Environment (BREATHE)	Anxiety disorders	Significant reduction in anxiety symptoms in G1, with no significant effect on participation.
		N: 40
		G1: 20 BREATHE
		G2: 20 control
Lyons et al. (2019)	Health Through Activity (HTA)	Cancer	G1 had a significantly higher frequency of leisure and IADL involvement. G2 showed minor improvements.
		N: 59
		G1: 30 HTA
		G2: 29 usual care
Wolf et al. (2019)	Cognitive Oriented Strategy Training Augmented rehabilitation – COSTAR versus	Post-stroke	G1 and G2 showed positive changes in most outcome measures and do not indicate a clear advantage that favors one intervention over the other. Compared to COSTAR, TST had a small effect on leisure activities with high demand and medium effect on IADL and general ACS.
	Task-specific Training – TST	N:44
		G1: 24 COSTAR
		G2: Control, TST
Newman et al. (2019)	Cognitive Self-Management	Breast cancer and cognitive impairment	Significant increases in self-perceived performance and satisfaction in daily life, and participation in IADL, social, and leisure activities. At follow-up, gains were not maintained.
		N:15
		Intervention group only
Ahn (2019)	Occupation-based intervention	Post-stroke	G1 with a significant increase in the quality of performance and participation in hemiparetic.
		N:43
		G1: 23 with intervention in occupation
		G2: 20 with intervention in actions

[1] Source: Elaborated by the authors.

Activity card sort and the occupational repertoire of older adults: an integrative literature review

Abstract