Background: Exercise has proven to be a tool improving health related quality of life in people with acquired brain injury (ABI) as part of multidisciplinary team during the subacute and chronic phase. While intervention studies and revisions have been increased in recent years, there is no consensus about the type, frequency and variables of control in exercise interventions. Besides, this collective need programs that respond to different functional levels, given the heterogeneity of people with ABI, not only because of the etiology, but also because of the severity differences over their deficits. The aim of this systematic review and meta-analysis is to summarize the evidence regarding the relationship between exercise and health related quality of life in subacute and chronic phase.Methods: A protocol of systematic review and meta-analysis will examine the benefits of physical exercise (PE) toward people with ABI will be conducted. A comprehensive search will be conducted in the following electronic databases: MEDLINE, The Cochrane Library, CINAHL, SportDiscus, and Web of Science from inception to July 2020. Independent review authors will evaluate the title and abstract for each trial and disagreements will be solved by discussion with a third author if necessary. Standard pairwise metaanalysis, including heterogeneity analysis, subgroup analysis, and sensitivity analysis, will be performed using the Stata software. The quality evaluation of this study will be completed using the Cochrane collaboration risk of bias tool and the risk of bias assessment will be conducted by the World Health Organization grading of recommendations, assessment, development, and evaluation. The review will be reported in accordance to the preferred reporting items for systematic reviews and meta-analyses statement.Results and Conclussion: This systematic review and meta-analysis protocol will provide an overview regarding the benefits of PE on functioning, social participation and quality of life toward people with ABI. The variability of outcomes across PE from the selected studies will provide important information for future trial designs. Results of the proposed review will inform practice and the design of future clinical trials. This study will summarize all the selected trials aimed at estimating the effectiveness of applying physical activity programs to ABI users.Systematic review registration number: PROSPERO CRD42020191779.Abbreviations: ABI = acquired brain injury, HRQoL = health related quality of life, ICF = International Classification of Functioning, Disability and Health, PA = physical activity, TBI = traumatic brain injury.
Background and objectives: Acquired brain injury (ABI) is the first cause of disability and physical activity (PA) is a key element in functional recovery and health-related quality of life (HRQoL) during the subacute and chronic phases. However, it is necessary to develop PA programs that respond to the heterogeneity and needs of this population. The aim of this study was to assess the effectiveness of a PA program on the HRQoL in this population. Materials and Methods: With regard to recruitment, after baseline evaluations, participants were assigned to either the intervention group (IG, n = 38) or the control group (CG, n = 35). Functional capacity, mood, quality of life and depression were measured pre- and post-intervention. The IG underwent the “Physical Activity and Sport for Acquired Brain Injury” (PASABI) program, which was designed to improve HRQoL (1-h sessions, two to four sessions/week for 18 weeks). The CG underwent a standard rehabilitation program without PA. Results: Results for the IG indicated significant differences and large effect sizes for the physical and mental dimensions of quality of life, as well as mood and functional capacity, indicating an increase in HRQoL. No significant differences were found for the CG across any variables. Conclusions: The PASABI program was feasible and beneficial for improving physiological and functionality variables in the IG. The wide range of the activities of the PASABI program allow its application to a large number of people with ABI, promoting health through PA, especially in the chronic phase.
Objective The aims of this systematic review and meta-analyses were to evaluate the effects of exercise on the functional capacity and quality of life (QoL) of people with acquired brain injury (ABI) and to analyze the influence of training variables. Methods Five electronic databases (MEDLINE, Cochrane Library, CINAHL, SportDiscus, and Web of Science) were searched until October 2021 for clinical trials or experimental studies examining the effects of exercise on the functional capacity and QoL in adults with ABI and comparing exercise interventions to nonexercise (usual care). Results Thirty eight studies were evaluated. A total sample of 2219 people with ABI (exercise, n = 1572; control, n = 647) were included in the quantitative analysis. A greater improvement was observed in walking endurance (z score = 2.84), gait speed (z score = 2.01), and QoL physical subscale (z score = 3.42) and QoL mental subscale (z score = 3.00) was observed in the experimental group than in the control group. In addition, an improvement was also observed in the experimental group in the “Timed “Up and Go” Test scores and balance, without differences with respect to the control group. Significant interactions were also observed between the rehabilitation phases, type, frequency, and volume of training, and overall effects. Conclusion The results suggest that exercise improves functional capacity and QoL regardless of model training, highlighting the effectiveness of long-term exercise that includes short sessions, with components such as strength, balance, and aerobic exercise.
Background People with acquired brain injury (ABI) frequently exhibit physical and psychosocial challenges, regarding the ‘body structure and function’, ‘activity’ and ‘participation’ ICF domains. Multidisciplinary approaches oriented to exercise therapy and social leisure activities seem to be fundamental to elicit neuroplastic adaptations to enhance physical recovery, as well as to improve the cognitive and behavioural sequels after ABI. The DIScover trial has been designed to support the development of fundamental movement and participation skills through a exercise therapy program based on racket sports. This program is a tool with a high social component that allows to integrate different body synergies and complex motor strategies that promote functional performance on both lower and upper limbs. Methods This randomized controlled trial with two parallel groups will aim to design and determine the effectiveness of a racket sports-based exercise therapy program in improving upper limb motor function, functional capacity, mobility, balance and quality of life towards people with ABI. Discussion The current study provides an holistic approach that combines exercise therapy and sport-based functional demands that can be easily integrated into participants’ daily life activities. Results from this trial may guide healthcare professionals working with patients with ABI to better guide this population in reaching optimal levels of health and physical activity levels. Trial registration number: NCT05358470
Exercise is an important element in the process of recovery from an acquired brain injury (ABI). However, specific guidance for exercise prescription and interventions in this population are missed. The aim of this study was to establish the key parameters to design and implement exercise programs based on the International Classification of Functioning, Disability, and Health (ICF) domains. A panel of experts that consisted of 13 professionals from neuro-rehabilitation centers evaluated the key parameters of this original proposal. The Heinemann methodology was used for all qualitative analyses. Additionally, Cronbach’s alpha was applied to the statistical analyses. According to the results, Cronbach’s alpha (0.97) indicated excellent internal consistency, and the experts perceptions ratified the proposed criteria to develop exercise programs for people with ABI. The proposed key parameters for the development of exercise programs for people with ABI based in ICF domains (body functions, activity—participation and environmental factors) bring a new, solid, and innovative tool for methodological design of these programs in sub-acute and chronic rehabilitation settings.
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