A systematic review of the efficacy of self-management programs for increasing physical activity in community-dwelling adults with acquired brain injury (ABI).
BACKGROUND
Individuals living with acquired brain injury, typically caused by stroke or trauma, are far less likely to achieve recommended levels of physical activity for optimal health and well-being. With a growing number of people living with chronic disease and disability globally, self-management programs are seen as integral to the management of these conditions and the prevention of secondary health conditions. However, to date, there has been no systematic review of the literature examining the efficacy of self-management programs specifically on physical activity in individuals with acquired brain injury, whether delivered face-to-face or remotely. Therefore, the purpose of this review is to evaluate the efficacy of self-management programs in increasing physical activity levels in adults living in the community following acquired brain injury. The efficacy of remote versus face-to-face delivery was also examined.


METHODS
A systematic review of the literature was conducted. Electronic databases were searched. Two independent reviewers screened all studies for eligibility, assessed risk of bias, and extracted relevant data.


RESULTS
Five studies met the inclusion criteria for this review. Studies were widely heterogeneous with respect to program content and delivery characteristics and outcomes, although all programs utilized behavioral change principles. Four of the five studies examined interventions in which physical activity was a component of a multifaceted intervention, where the depth to which physical activity specific content was covered, and the extent to which skills were taught and practiced, could not be clearly established. Three studies showed favorable physical activity outcomes following self-management interventions for stroke; however, risk of bias was high, and overall efficacy remains unclear. Although not used in isolation from face-to-face delivery, remote delivery via telephone was the predominant form of delivery in two studies with support for its inclusion in self-management programs for individuals following stroke.


CONCLUSIONS
The efficacy of self-management programs in increasing physical activity levels in community-dwelling adults following acquired brain injury (ABI) is still unknown. Research into the efficacy of self-management programs specifically aimed at improving physical activity in adults living in the community following acquired brain injury is needed. The efficacy of remote delivery methods also warrants further investigation.


BACKGROUND
PROSPERO CRD42013006748.
Department of Health Professions, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, NSW, 2109, Australia. taryn.jones@mq.edu.au.|Centre for Physical Health, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, 2109, Australia. taryn.jones@mq.edu.au.
Taryn M
TM
Jones
Department of Health Professions, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, NSW, 2109, Australia. catherine.dean@mq.edu.au.|Centre for Physical Health, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, 2109, Australia. catherine.dean@mq.edu.au.
Catherine M
CM
Dean
Department of Health Professions, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, NSW, 2109, Australia. julia.hush@mq.edu.au.|Centre for Physical Health, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, 2109, Australia. julia.hush@mq.edu.au.
Julia M
JM
Hush
Department of Psychology, Centre for Emotional Health, Building C3A, Level 7, Macquarie University, Sydney, 2109, Australia. blake.dear@mq.edu.au.|Centre for Physical Health, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, 2109, Australia. blake.dear@mq.edu.au.
Blake F
BF
Dear
Department of Psychology, Centre for Emotional Health, Building C3A, Level 7, Macquarie University, Sydney, 2109, Australia. nick.titov@mq.edu.au.|Centre for Physical Health, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, 2109, Australia. nick.titov@mq.edu.au.
Nickolai
N
Titov
D000328:Adult; D001930:Brain Injuries / Q000628:therapy; D002908:Chronic Disease; D019468:Disease Management; D015444:Exercise; D006801:Humans; D017063:Outcome Assessment, Health Care; D012648:Self Care; D020521:Stroke / Q000628:therapy