A Physical Activity Clinical Practice Guideline for People With Moderate to Severe Traumatic Brain Injury

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.

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Publication Details

Journal
Clinical and Public Health Guidelines
Published
2025-08-14
DOI
https://doi.org/10.1002/gin2.70035
Primary Topic
Stroke Rehabilitation and Recovery
Type
article
Field-Weighted Citation Impact
0.00

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article

A Physical Activity Clinical Practice Guideline for People With Moderate to Severe Traumatic Brain Injury

Catherine Sherrington, Nick Rushworth, Liam Johnson, Gavin P. Williams et al.
Clinical and Public Health Guidelines
Stroke Rehabilitation and Recovery
article

A Physical Activity Clinical Practice Guideline for People With Moderate to Severe Traumatic Brain Injury

Catherine Sherrington, Nick Rushworth, Liam Johnson, Gavin P. Williams, Anne Tiedemann, Sakina Chagpar, Gabrielle Vassallo, Luke Wolfenden, Abby Haynes, Anthony David Okely, Catherine Carty, Kerry West, Zachary Munn, Sean Tweedy, Leanne Hassett, Adrian Bauman, Kelly Clanchy, Adam M. Scheinberg, Grahame Simpson, Rhys Ashpole, Belinda Wang, Kate Heine
article en

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.

Clinical and Public Health GuidelinesVol. 2(4)
Griffith University (AU), The University of Sydney (AU), Queensland University of Technology (AU), The University of Queensland (AU), The University of Melbourne (AU), University of Wollongong (AU), Epworth Hospital (AU), House of Representatives (NL), Children's Hospital at Westmead (AU), Munster Technological University (IE), Together (US), Institute for Musculoskeletal Health (AU), New South Wales Institute of Psychiatry (AU), Northern Sydney Local Health District (AU), Sydney Local Health District (AU), Murdoch Children's Research Institute (AU), Hunter New England Local Health District (AU), Melbourne Health (AU), South Western Sydney Local Health District (AU), The University of Adelaide (AU), RMIT University (AU), Australian Catholic University (AU)
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
Openalex Percentile: Top 73%
Stroke Rehabilitation and Recovery
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