Occupational therapy interventions in community settings for people with acquired brain injury: a scoping review

Abstract

Acquired brain injury (ABI) is one of the leading causes of disability worldwide, generating growing interest in community-based rehabilitation interventions. Occupational therapy, with its focus on participation and performance in meaningful occupations, plays a key role in this field. However, the evidence on community-based interventions led by occupational therapists remains scattered and poorly systematised. To analyse the scientific evidence on community-based interventions developed by occupational therapists for people with ABI, characterising their components, theoretical frameworks, assessment tools, facilitators, and barriers. A scoping review was conducted following Arksey and O’Malley’s framework, supported by PRISMA-ScR. Studies published between 2019 and 2024 in English or Spanish were included and identified across four databases. A total of 23 studies met the inclusion criteria. A wide heterogeneity in intervention types, outcome measures, and populations was observed. The most common approaches included real-world community settings, assistive technologies, and telerehabilitation. There was limited use of explicit theoretical frameworks and a broad dispersion of assessment tools. Key facilitators included family and social support, while the main barriers involved economic, cognitive, and interinstitutional coordination difficulties. Community-based interventions led by occupational therapists show promising results but face important challenges related to theoretical grounding, methodological standardisation, and contextual adaptability. More rigorous and culturally relevant studies are needed to strengthen their effectiveness and sustainability.