Development of an Australian physical activity guideline for people living with traumatic brain injury
Abstract Overview
Background: In 2020 the World Health Organization (WHO) released the first international physical activity guideline for people living with disability. However, the evidence informing the guideline was not specific to people with traumatic brain injury (TBI), nor the rehabilitation setting.
Purpose: To develop an Australian physical activity clinical practice guideline for health professionals working with people with moderate-to-severe TBI.
Methods: We used a Grading of Recommendations Assessment, Development and Evaluation (GRADE) ADOLOPMENT approach to determine whether to ‘adapt’ or ‘adopt’ the WHO guideline or develop de novo recommendations. We established guideline leadership and development groups, conducted a systematic review to identify direct evidence in moderate-to-severe TBI, and reviewed guidelines in other health conditions (e.g., stroke) to identify indirect evidence. To inform future implementation, we conducted an audit of Australian brain injury rehabilitation services and qualitative consultations with key stakeholders.
Results: The clinical practice guideline developed incorporated 10 de novo recommendations to support health professionals’ clinical decision-making and increase uptake of physical activity by people of all ages living with moderate-to-severe TBI. Twenty-six brain injury services were audited, with 54-100% of services prescribing physical activity interventions consistent with the guideline recommendations, indicating feasibility. Data from stakeholder focus groups indicated good acceptability of physical activity interventions, however barriers to implementation e.g., identifying and accessing community physical activity, were identified.
Conclusions: The GRADE ADOLOPMENT process resulted in de novo recommendations to support increased physical activity participation for people with moderate-to-severe TBI. There remains a need for more direct evidence in this population, as well as research to evaluate how the guideline can be implemented into clinical practice.
Practical implications: Physical activity interventions tailored to the individual’s goals and needs should be standard clinical practice for health professionals working with people with moderate-to-severe TBI.
Funding: Australian Medical Research Future Fund TBI Mission, 2020 (MRF2009099).
Additional Authors
Name: Liam Johnson
Affiliation: The University of Melbourne/ The University of Sydney
Presenting Author: no
Name: Gavin Williams
Affiliation: Epworth HealthCare/University of Melbourne, Melbourne, Australia
Presenting Author: no
Name: Sakina Chagpar
Affiliation: The University of Sydney, Sydney, Australia
Presenting Author: no
Name: Catherine Sherrington
Affiliation: The University of Sydney, Sydney, Australia
Presenting Author: no
Name: Gabrielle Vassallo
Affiliation: Consumer representative
Presenting Author: no
Name: Abby Haynes
Affiliation: The University of Sydney
Presenting Author: no
Name: Nick Rushworth
Affiliation: Brain Injury Australia
Presenting Author: no
Name: Sean Tweedy
Affiliation: The University of Queensland, Queensland, Australia
Presenting Author: no
Name: Grahame Simpson
Affiliation: Liverpool Brain Injury Rehabilitation Unit, Sydney, Australia
Presenting Author: no
Name: Adam Scheinberg
Affiliation: Murdoch Children’s Research Institute, Melbourne, Australia
Presenting Author: no
Name: Luke Wolfenden
Affiliation: Hunter New England Local Health District, University of Newcastle, Newcastle, Australia
Presenting Author: no
Name: Kelly Clanchy
Affiliation: Griffith University, Queensland, Australia
Presenting Author: no
Name: Anne Tiedemann
Affiliation: The University of Sydney, Sydney, Australia
Presenting Author: no
Name: _ On behalf of BRIDGES research team
Affiliation: The University of Sydney
Presenting Author: no
Information
Study Type: Policy (e.g. policy or guideline development)
Subtheme: Inequalities
Population Group: Disabled people
Setting: Healthcare
Submitting Author
Leanne Hassett
Associate Professor
The University of Sydney
Australia
