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BMJ Open. 2019 Feb 15;9(2):e024838. doi: 10.1136/bmjopen-2018-024838.

Frailty in the context of rehabilitation interventions for adults: protocol for a scoping review.

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Rehabiliation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.
Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.
LIFEspan Service, Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Toronto Rehabilitation Institution, University Health Network, Cardiac Rehabilitation and Prevention Program, Toronto, Ontario, Canada.
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.



Although a growing number of frail adults can benefit from rehabilitation services, few are included in rehabilitation services, and reasons for their exclusion are not well understood. To inform research directions in rehabilitation for all adults (aged 18 years and older), we will conduct a scoping review to describe (1) the characteristics of frail adult individuals included in rehabilitation interventions (eg, age range, inclusion and exclusion criteria that are applied), (2) the type of rehabilitation interventions that are used for individuals who are considered frail and (3) the commonly reported outcome measures used for these rehabilitation interventions.


This scoping review will be guided by Arksey and O'Malley's methodological framework. Ageline, Cochrane CINAHL, Embase, MEDLINE, Pubmed, OTSeeker, PeDRO, PsycINFO and Scopus databases will be systematically searched for articles relevant to rehabilitation interventions and health services. To be eligible for inclusion, studies must report on the outcomes from an intervention that involves all individuals (aged 18 and older) who are considered frail. Only English-language, peer-reviewed publications between 1990 and 2018 will be included. A two-step screening process will consist of (1) a title and abstract review and (2) full-text review. In both levels of screening, a minimum of two investigators will independently screen the title and abstract of all retrieved citations for inclusion against a set of minimum inclusion criteria.


Results will be presented as a narrative synthesis to facilitate the integration of diverse evidence.


This study does not require ethics approval. By examining the current state of rehabilitation interventions for frail adults, this scoping review can offer insight into rehabilitation needs and models of care. It can also guide future rehabilitation research for frail adults. We will share our results with frail adults during a consultation meeting and publish a manuscript in a peer-reviewed rehabilitation journal.


frailty; rehabilitation medicine; scoping review

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