A Physical Activity Clinical Practice Guideline for People With Moderate to Severe Traumatic Brain Injury
Year: 2025
Type: article
Abstract: ABSTRACT Introduction In 2020 the World Health Organization (WHO) released the first international public health guideline on physical activity for people with disability. However, the evidence informing the guideline was not specific to people with traumatic brain injury (TBI), nor did it provide guidance for health professionals to promote and deliver physical activity in rehabilitation. We aimed to develop an Australian Physical Activity Clinical Practice Guideline for people with moderate to severe TBI (msTBI). Questions This guideline sought to answer the following question: ‘ Should [physical activity intervention] compared to control be used for [people with] msTBI?’ The question was adapted to five physical activity interventions (structured aerobic exercise, muscle strengthening, gait/balance/functional exercise, sport and physical recreation, and promotion of physical activity) and two populations (children and adolescents; adults and older adults). Methods We used the 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 steering, leadership and development groups, conducted a rapid review to identify direct evidence in msTBI, and reviewed guidelines in other relevant health conditions (i.e., stroke, cerebral palsy) to identify indirect evidence. To address evidence gaps and inform implementation considerations, we conducted an audit of brain injury services in Australia and qualitative consultations with key interest‐holders, including people with msTBI. Recommendations The guideline incorporates 10 de novo recommendations for people with msTBI for the delivery and promotion of physical activity across the rehabilitation continuum of care. The guideline includes good practice and precautionary points, and subgroup considerations to guide usability and implementation. Data from the clinical audit and interest‐holder focus groups indicated feasibility and acceptability of physical activity interventions. The guideline seeks to support health professionals' clinical decision‐making and increase uptake of physical activity by people with msTBI.
DOI: 10.1002/gin2.70035
Authors: Leanne Hassett, Liam Johnson, Gavin Williams, Rhys Ashpole, Adrian Bauman, Catherine Carty, Sakina Chagpar, Kelly Clanchy, Abby Haynes, Kate Heine, Zachary Munn, Anthony Okely, Nick Rushworth, Adam Scheinberg, Catherine Sherrington, Grahame Simpson, Anne Tiedemann, Sean Tweedy, Gabrielle Vassallo, Belinda Wang, Kerry West, Luke Wolfenden, the BRIDGES Guideline Development Group members
Institutions: The University of Sydney, Institute for Musculoskeletal Health, Sydney Local Health District, Western Sydney Local Health District, The University of Melbourne, Epworth Hospital, Australian Catholic University, Insurance and Care NSW, Munster Technological University, Griffith University, The University of Adelaide, University of Wollongong, Murdoch Children's Research Institute, Northern Sydney Local Health District, South Western Sydney Local Health District, The University of Queensland, Children's Hospital at Westmead, Hunter New England Local Health District
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,200
Funders: Johns Hopkins University, Hunter New England Local Health District, Children’s Hospital of Wisconsin Research Institute, Western Sydney Local Health District, Murdoch Children's Research Institute, Australian Government, Australian Catholic University, University of Sydney, University of Wollongong, Griffith University, University of Queensland, Faculty of Health and Medical Sciences, University of Western Australia, Munster Technological University, Medical Research Council, National Health and Medical Research Council, Faculty of Medicine and Health, University of Sydney, Medical Research Future Fund
Award: G8137252852
OpenAlex ID: W4413340740