Community-based rehabilitation approaches in outdoor settings: a systematic review of people with disabilities' and professionals' experiences and perceptions

This systematic review sheds light on the link between community-based rehabilitation (CBR) approaches and outdoor settings. The aim was to examine and synthesise qualitative knowledge on people with disabilities' and professionals' experiences and perceptions regarding facilitators and barriers to CBR approaches in outdoor settings. The Interpretive Description methodology guided the interpretive synthesis. Nine articles met the inclusion criteria. The synthesis revealed four themes: Ability to Overcome Challenges, Outdoor Adaptive Activities, Inclusive Social Communities and Culture of Reciprocal Interaction. The link between CBR approaches and outdoor settings seemed to empower participation opportunities and social inclusion of people with disabilities, which stimulated equality among all people involved. However, to transfer potential benefits into society, beyond the formalised programme contexts, more focus is needed on creation of inclusive environments. These inclusive environments entail cultural as well as physical changes together with political commitment.Points of interest People with disabilities are often restricted by physical barriers and misconceptions about their abilities when they attempt to participate in the community. This systematic review found that rehabilitation based in the community with focus on outdoor adaptive activities, gave people with disabilities an opportunity to learn how to overcome challenges of everyday living. Outdoor adaptive activities serve as a social gathering point, where people of all abilities can share experiences and be equally included in social communities. Professionals play a key role to ensure safety and provide social support, but they express a lack of experience and shared direction on what this approach to rehabilitation involves. This study recommends that inclusive environments and political commitment are necessary for a cultural development towards more equality in relations between all people in society.