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

Lilian Dias Bernardo

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

https://orcid.org/0000-0001-5234-4225

Tatiana Barcelos Pontes

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

https://orcid.org/0000-0002-1870-7157

Klysna Imbroinisio de Souza

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

https://orcid.org/0000-0002-9397-7747

Rafaela Guilherme Ferreira

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

https://orcid.org/0000-0002-0843-3965

Tainá Maria Silva Deodoro

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

https://orcid.org/0000-0003-0469-3994

Pedro Henrique Tavares Queiroz de Almeida

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

University of Western Ontario, London, Canadá.

https://orcid.org/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)Chan, V. W. K., Chung, J. C. C., & Packer, T. L. (2006). Validity and reliability of the Activity Card Sort-Hong Kong version. OTJR, 26(4), 152-158.	Transcultural Adaptation	ACS-Hong Kong consists of 65 activities. Four cultural activities were included.
Packer et al. (2008)Packer, T. L., Boshoff, K., & DeJonge, D. (2008). Development of the activity card sort-Australia. Australian Occupational Therapy Journal, 55(3), 199-206.		ACS-Australia consists of 82 activities, divided into domestic, social/educational, and leisure activities.
Laver-Fawcett & Mallinson (2013)Laver-Fawcett, A. J., & Mallinson, S. H. (2013). Development of the Activity Card Sort: united Kingdom version (ACS-UK). OTJR, 33(3), 134-145.		ACS-UK consists of 91 activities. The response variable “do more” was inserted.
Uemura et al. (2018)Uemura, J. I., Tanikaga, M., Tanaka, M., Shimose, M., Hoshino, A., & Igarashi, G. (2018). Selection of activity items for development of the Activity Card Sort – Japan version. OTJR, 39(1), 23-31.		ACS-Japan consists of 72 activities. Eight cultural activities were included.
Alegre-Muelas et al. (2019)Alegre-Muelas, C., Alegre-Ayala, J., Huertas-Hoyas, E., Martínez-Piédrola, M. R., Pérez-Corrales, J., & Máximo-Bocanegra, N. (2019). Spanish transcultural adaptation of the Activity Card Sort. Occupational Therapy International, 2019, 1-9. http://dx.doi.org/10.1155/2019/4175184. http://dx.doi.org/10.1155/2019/4175184...		ACS-Japan consists of 72 activities. Eight cultural activities were included.
		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)Sachs, D., & Josman, N. (2003). The Activity Card Sort: a factor analysis. OTJR, 23(4), 165-174.	Utility	ACS-Israel, ACS-United Kingdom, ACS-Holland: Intelligent and had good acceptance and clinical utility by the older adults.
Eriksson et al. (2011)Eriksson, G. M., Chung, J. C. C., Beng, L. H., Hartman-Maeir, A., Yoo, E., & Orellano, E. M. (2011). Occupations of older adults: a cross cultural description. OTJR, 31(4), 182-192.
Laver-Fawcett et al. (2016)Laver-Fawcett, A., Brain, L., Brodie, C., Cardy, L., & Manaton, L. (2016). The face validity and clinical utility of the Activity Card Sort – United Kingdom (ACS-UK). British Journal of Occupational Therapy, 79(8), 492-504.
Poerbodipoero et al. (2016)Poerbodipoero, S. J., Sturkenboom, I. H., Van Hartingsveldt, M. J., Nijhuis-Van, M. W. G., & Graff, M. J. (2016). The construct validity of the Dutch version of the Activity Card Sort. Disability and Rehabilitation, 38(19), 1943-1951.
Jong et al. (2012)Jong, A. M., Van-Nes, F. A., & Lindeboom, R. (2012). The Dutch Activity Card Sort institutional version was reproducible, but biased against women. Disability and Rehabilitation, 34(18), 1550-1555.	Inter and intra-examiner agreement	High level of inter and intra-examiner agreement.
Katz et al. (2003)Katz, N., Karpin, H., Lak, A., Furman, T., & Hartman-Maeir, A. (2003). Participation in occupational performance: reliability and validity of the Activity Card Sort. OTJR, 23(1), 10-17.	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)Chan, V. W. K., Chung, J. C. C., & Packer, T. L. (2006). Validity and reliability of the Activity Card Sort-Hong Kong version. OTJR, 26(4), 152-158.		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)Doney, R. M., & Packer, T. L. (2008). Measuring changes in activity participation of older Australians: validation of the Activity Card Sort–Australia. Australasian Journal on Ageing, 27(1), 33-37.
Lyons et al. (2010)Lyons, K. D., Li, Z., Tosteson, T. D., Meehan, K., & Ahles, T. A. (2010). Consistency and construct validity of the Activity Card Sort (modified) in measuring activity resumption after stem cell transplantation. The American Journal of Occupational Therapy, 64(4), 562-569.
Orellano et al. (2012)Orellano, E. M., Ito, M., Dorne, R., Irizarry, D., & Dávila, R. (2012). Occupational participation of older adults: reliability and validity of the Activity Card Sort-Puerto Rican version. OTJR, 32(1), 266-272.
Hamed & Holm (2013)Hamed, R., & Holm, M. B. (2013). Psychometric properties of the Arab heritage Activity Card Sort. Occupational Therapy International, 20(1), 23-34.
Poerbodipoero et al. (2016)Poerbodipoero, S. J., Sturkenboom, I. H., Van Hartingsveldt, M. J., Nijhuis-Van, M. W. G., & Graff, M. J. (2016). The construct validity of the Dutch version of the Activity Card Sort. Disability and Rehabilitation, 38(19), 1943-1951.
Laver-Fawcett et al. (2016)Laver-Fawcett, A., Brain, L., Brodie, C., Cardy, L., & Manaton, L. (2016). The face validity and clinical utility of the Activity Card Sort – United Kingdom (ACS-UK). British Journal of Occupational Therapy, 79(8), 492-504.

Authors and year	Context	Outcomes
	Level of participation in:
Hartman-Maeir et al. (2007a)Hartman-Maeir, A., Eliad, Y., Kizoni, R., Nahaloni, I., Kelberman, H., & Katz, N. (2007a). Evaluation of a long-term community based rehabilitation program for adult stroke survivors. NeuroRehabilitation, 22(4), 295-301.	Post-stroke individuals	The stroke had a serious and lasting impact on the level of participation.
Spitzer et al. (2011)Spitzer, J., Tse, T., Baum, C. M., & Carey, L. M. (2011). Mild impairment of cognition impacts on activity participation after stroke in a community-dwelling Australian cohort. OTJR, 31(1), S8-S15.	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)Wolf, T. J., Brey, J. K., Baum, C., & Connor, L. T. (2012). Activity participation differences between younger and older individuals with stroke. Brain Impairment, 13(1), 16-23.	With/without somatosensory impairment	Those with cognitive deficits reduced the high demand for leisure and social/educational activities.
Tse et al. (2017Tse, T., Douglas, J., Lentin, P., Lindén, T., Churilov, L., & Ma, H. (2017). Reduction in retained activity participation is associated with depressive symptoms 3 months after mild stroke: an observational cohort study. Journal of Rehabilitation Medicine, 49, 120-127., 2018Tse, T., Linden, T., Churilov, L., Davis, S., Donnan, G., & Carey, L. M. (2018). Longitudinal changes in activity participation in the first year post-stroke and association with depressive symptoms. Disability and Rehabilitation, 41, 2548-2555.)		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)Carey, L.M., Matyas, T.A., & Baum, C. (2018). Effects of somatosensory impairment on participation after stroke. American Journal of Occupational Therapy, 72(3), 7203205100. http://dx.doi.org/10.5014/ajot.2018.025114. http://dx.doi.org/10.5014/ajot.2018.0251...		At follow-up, without the presence of depression, the preservation of activities was resumed, especially social and leisure activities.
Verberne et al. (2019)Verberne, D., Tse, T., Matyas, T., Baum, C., Post, M., Carey, L., & Van Heugten, C. (2019). Comparing participation outcome over time across international stroke cohorts: outcomes and methods. Archives of Physical Medicine and Rehabilitation, 100(11), 2096-2105.
Cipriani et al. (2006)Cipriani, J., Faig, S., Ayrer, K., Brown, L., & Johnson, N. C. (2006). Altruistic activity patterns among long-term nursing home residents. Physical & Occupational Therapy in Geriatrics, 24(3), 45-61.	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)Albert, S. M., Bear-lehman, J., & Burkhardt, A. (2009). Lifestyle-adjusted function: variation beyond BADL and IADL competencies. The Gerontologist, 49(6), 767-777.	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)Perlmutter, M. S., Bhorade, A., Gordon, M., Hollingsworth, H. H., & Baum, M. C. (2010). Cognitive, visual, auditory, and emotional factors that affect participation in older adults. The American Journal of Occupational Therapy, 64(4), 570-579.	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)Duncan, R. P., & Earhart, G. M. (2011). Measuring participation in individuals with parkinson disease: relationships with disease severity, quality of life, and mobility. Disability and Rehabilitation, 33(15-16), 1440-1446.	Mild cognitive impairment (CCL)	Age, for retirees, interfered negatively in participation.
Lyons et al. (2011Lyons, K. D., Hull, J. G., Root, L. D., Kimtis, E., Schaal, A. D., Stearns, D. M., Williams, I. C., Meehan, K. R., & Ahles, T. A. (2011). A pilot study of activity engagement in the first six months after stem cell transplantation. Oncology Nursing Forum, 38(1), 75-83., 2013Lyons, K. D., Lambert, L. A., Balan, S., Hegel, M. T., & Bartels, S. (2013). Changes in activity levels of older adult cancer survivors. OTJR, 33(1), 31-39.)	Parkinson's disease (PD)	Male retirees had higher participation in activities than women. The same was observed in transplant recipients.
Orellano et al. (2014)Orellano, E. M., Mountain, G., Varas, N., & Labault, N. (2014). Occupational competence strategies in old age: a mixed-methods comparison between Hispanic women with different levels of daily participation. OTJR, 34(1), 32-40.	Hip fracture	For healthy elderly people, the most significant activities were chosen by culture.
Lee (2014)Lee, S. H. (2014). Activity engagement of aging retirees in South Korea. Journal of Physical Therapy Science, 26(2), 239-241.	Cancer	The elderly with fractures recovered low-demand leisure activities up to 6 months after the injury.
Marken & Howard (2014)Marken, D. M., & Howard, J. B. (2014). Grandparents raising grandchildren: the influence of a late-life transition on occupational engagement. Physical & Occupational Therapy in Geriatrics, 32(4), 381-396.	Stem cell transplants
Chapman & Nelson (2014)Chapman, L., & Nelson, D. (2014). Person-centered, community-based occupational therapy for a man with Parkinson’s disease: a case study. Activities, Adaptation and Aging, 38(2), 94-112.	Vulnerable
Fox et al. (2017)Fox, K., Morrow-Howell, N., Herbers, S., Battista, P., & Baum, C. M. (2017). Activity disengagement: understanding challenges and opportunities for reengagement. Occupational Therapy International, 2017, 1-7. http://dx.doi.org/10.1155/2017/1983414. http://dx.doi.org/10.1155/2017/1983414...	Institutionalized
Rodakowski et al. (2018)Rodakowski, J., Becker, A. M., & Golias, K. W. (2018). Activity-based goals generated by older adults with mild cognitive impairment. OTJR, 38(2), 84-88.	Healthy, community residents
Segev-Jacubovski et al. (2018)Segev-Jacubovski, O., Magen, H., & Maeir, A. (2018). Functional ability, participation, and health-related quality of life after hip fracture. OTJR, 39(1), 41-47.	Retired
	Take care of grandchildren
Kniepmann (2012Kniepmann, K. (2012). Female family carers for survivors of stroke: occupational loss and quality of life. British Journal of Occupational Therapy, 75(5), 208-216., 2014Kniepmann, K. (2014). Family caregiving for husbands with stroke: an occupational perspective on leisure in the stress process. OTJR, 34(3), 131-140.)	Caregivers	There was a reduction in participation after taking on the role of caregivers.
Kniepmann & Cupler (2014)Kniepmann, K., & Cupler, M. H. (2014). Occupational changes in caregivers for spouses with stroke and aphasia. British Journal of Occupational Therapy, 77(1), 10-18.	Post-stroke older adults	The greater the social support, the greater the level of participation.
Rosenwax et al. (2014)Rosenwax, L., Malajczuk, S., & Ciccarelli, M. (2014). Change in carers’ activities after the death of their partners. Supportive Care in Cancer, 22(3), 619-626.	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)Hartman-Maeir, A., Soroker, N., Oman, S. D., & Katz, N. (2003). Awareness of disabilities in stroke rehabilitation: a clinical trial. Disability and Rehabilitation, 25(1), 35-44.	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)Hartman-Maeir, A., Soroker, N., Ring, H., Avni, N., & Katz, N. (2007b). Activities, participation and satisfaction one-year post stroke. Disability and Rehabilitation, 29(7), 559-566.	Post-stroke satisfaction and emotional status	There was a negative correlation between satisfaction and depression at the level of participation.
Spitzer et al. (2011)Spitzer, J., Tse, T., Baum, C. M., & Carey, L. M. (2011). Mild impairment of cognition impacts on activity participation after stroke in a community-dwelling Australian cohort. OTJR, 31(1), S8-S15.	Post-stroke cognition and mood	Mild cognitive impairment was associated with a lower level of participation.
Jung et al. (2015)Jung, H., Shin, H. H., Choi, Y. W., & Kim, K. M. (2015). The relationship between fall efficacy and activity level in older adults. Physical & Occupational Therapy in Geriatrics, 33(1), 53-63.	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)Engel-Yeger, B., & Rosenblum, S. (2017). The relationship between sensory-processing patterns and occupational engagement among older persons. Canadian Journal of Occupational Therapy, 84(1), 10-21.	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)Shpigelman, S. R., Sternberg, S., & Maeir, A. (2017). Beyond memory problems: multiple obstacles to health and quality of life in older people seeking help for subjective memory complaints. Disability and Rehabilitation, 41(1), 19-25.	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)Seaton, L., & Brown, T. (2018). The relationship between body function and structure factors and the activity-participation of healthy community-dwelling older adults. Physical & Occupational Therapy in Geriatrics, 36(4), 121-135. http://dx.doi.org/10.1080/02703181.2018.1443193. http://dx.doi.org/10.1080/02703181.2018....	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)Hanna, E., Janssen, H., Crowfoot, G., Mason, G., Vyslysel, G., Sweetapple, A., Callister, R., & English, C. (2019). Participation, fear of falling, and upper limb impairment are associated with high sitting time in people with stroke. Occupational Therapy in Health Care, 33(2), 181-196. http://dx.doi.org/10.1080/07380577.2019.1587675. http://dx.doi.org/10.1080/07380577.2019....	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)Tse, T., Douglas, J., Lentin, P., Lindén, T., Churilov, L., & Ma, H. (2017). Reduction in retained activity participation is associated with depressive symptoms 3 months after mild stroke: an observational cohort study. Journal of Rehabilitation Medicine, 49, 120-127.	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)Tucker, F. M., Edwards, D. F., Mathews, L. K., Baum, C. M., & Connor, L. T. (2012). Modifying health outcome measures for people with aphasia. The American Journal of Occupational Therapy, 66(1), 42-50.	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)Wolf, T., & Koster, J. (2013). Perceived recovery as a predictor of physical activity participation after mild stroke. Disability and Rehabilitation, 35(14), 1143-1148.	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)Rosenwax, L., Malajczuk, S., & Ciccarelli, M. (2014). Change in carers’ activities after the death of their partners. Supportive Care in Cancer, 22(3), 619-626.	Women living alone
Fox et al. (2017)Fox, K., Morrow-Howell, N., Herbers, S., Battista, P., & Baum, C. M. (2017). Activity disengagement: understanding challenges and opportunities for reengagement. Occupational Therapy International, 2017, 1-7. http://dx.doi.org/10.1155/2017/1983414. http://dx.doi.org/10.1155/2017/1983414...	Vulnerable older adults

Authors and year	Context:	Target Audience:	Outcomes
	Intervention	Indivíduals with
		Nº of participants (N)
		Groups (G)
Hartman-Maeir et al. (2007a) Hartman-Maeir, A., Eliad, Y., Kizoni, R., Nahaloni, I., Kelberman, H., & Katz, N. (2007a). Evaluation of a long-term community based rehabilitation program for adult stroke survivors. NeuroRehabilitation, 22(4), 295-301.	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)Packer, T. L., Girdler, S., Boldy, D. P., Dhaliwal, S. S., & Crowley, M. (2009). Vision self-management for older adults: a pilot study. Disability and Rehabilitation, 31(16), 1353-1361.	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)Girdler, S. J., Boldy, D. P., Dhaliwal, S. S., Crowley, M., & Packer, T. L. (2010). Vision self-management for older adults: a randomised controlled trial. The British Journal of Ophthalmology, 94(2), 223-228.		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)Ghahari, S., Packer, L. T., & Passmore, A. E. (2010). Effectiveness of an online fatigue self-management programme for people with chronic neurological conditions: a randomized controlled trial. Clinical Rehabilitation, 24(8), 727-744.	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)Ghahari, S., & Packer, T. (2012). Effectiveness of online and face-to-face fatigue self-management programmes for adults with neurological conditions. Disability and Rehabilitation, 34(7), 564-573.		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)Henshaw, E., Polatajko, H., McEwen, S., Ryan, J. D., & Baum, C. M. (2011). Cognitive approach to improving participation after stroke: two case studies. The American Journal of Occupational Therapy, 65(1), 55-63.	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)Foster, E. R., Golden, L., Duncan, R. P., & Earhart, G. M. (2013). Community-based Argentine tango dance program is associated with increased activity participation among individuals with Parkinson’s disease. Archives of Physical Medicine and Rehabilitation, 94(2), 240-249.	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)Wehofer, L., Goodson, N., & Shurtleff, T. L. (2013). Equine assisted activities and therapies: a case study of an older adult. Physical & Occupational Therapy in Geriatrics, 31(1), 71-87.	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)Sturkenboom, I. H. W. M., Graff, M. J. L., Hendriks, J. C. M., Veenhuizen, Y., Munneke, M., & Bloem, B. R. (2014). Efficacy of occupational therapy for patients with Parkinson’s disease: a randomised controlled trial. Lancet Neurology, 13(6), 557-566.	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)Sabari, J. S., Ortiz, D., Pallatto, K., Yagerman, J., Glazman, S., & Bodis-Wollner, I. (2015). Activity engagement and health quality of life in people with Parkinson’s disease. Disability and Rehabilitation, 37(16), 1411-1415.	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)McNamara, B., Rosenwax, L., Lee, E. A., & Same, A. (2016). Evaluation of a healthy ageing intervention for frail older people living in the community. Australasian Journal on Ageing, 35(1), 30-35.	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)Kaizerman-Dinerman, A., Roe, D., & Josman, N. (2018). An efficacy study of a metacognitive group intervention for people with schizophrenia. Psychiatry Research, 270, 1150-1156.	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)Kaizerman-Dinerman, A., Josman, N., & Roe, D. (2019). The use of cognitive strategies among people with schizophrenia: a randomized comparative study. The Open Journal of Occupational Therapy, 7(3), 1-12.		G2: 41 control	G1 used more cognitive strategies (secret and open) and predicted participation.
Wetherell et al. (2018)Wetherell, J. L., Bower, E. S., Johnson, K., Chang, D. G., Ward, S. R., & Petkus, A. J. (2018). Integrated exposure therapy and exercise reduces fear of falling and avoidance in older adults: a randomized pilot study. The American Journal of Geriatric Psychiatry, 26(8), 849-859.	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)Kim, K. S., & Cho, Y. S. (2018). The effects of an occupation-centered cognitive rehabilitation program on elderly individuals with mild cognitive impairment. Journal of Physical Therapy Science, 30(2), 332-334.	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)Gould, C. E., Kok, B. C., Ma, V. K., Wetherell, J. L., Sudheimer, K., & Beaudreau, S. A. (2018). Video-delivered relaxation intervention reduces late-life anxiety: A pilot randomized controlled trial. The American Journal of Geriatric Psychiatry, 27(5), 514-525.	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)Lyons, K. D., Bruce, M. L., Hull, J. G., Kaufman, P. A., Li, Z., & Stearns, D. M. (2019). Health through activity: initial evaluation of an in-home intervention for older adults with cancer. The American Journal of Occupational Therapy, 73(5), 1-11.	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)Wolf, T. J., Doherty, M., Boone, A., Rios, J., Polatajko, H., Baum, C., & McEwen, S. (2019). Cognitive Oriented Strategy Training Augmente Rehabilitation (COSTAR) for ischemic stroke: a pilot exploratory randomized controlled study. Disability and Rehabilitation, 43(2), 201-210.	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)Newman, R., Lyons, K. D., Coster, W. J., Wong, J., Festa, K., & Ko, N. Y. (2019). Feasibility, acceptability and potential effectiveness of an occupation-focused cognitive self-management program for breast cancer survivors. British Journal of Occupational Therapy, 82(10), 604-611.	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)Ahn, S. (2019). Effectiveness of occupation-based interventions on performance’s quality for hemiparetic stroke in community-dwelling: a randomized clinical trial study. NeuroRehabilitation, 44(2), 275-282.	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] 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.

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

Abstract

Introduction

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