A systematic review of the efficacy of self-management programs for increasing physical activity in community-dwelling adults with acquired brain injury (ABI)

Question: Do self-management programs improve physical activity in adults with acquired brain injury (ABI)?
Design: Systematic review with data from randomised or quasi-randomised controlled trials synthesised in narrative format.
Participants: Community-dwelling adults with non-degenerative ABI.
Intervention Self-management program with at least one component focused on increasing physical activity.
Outcome measures: Measure of physical activity (objective or self-report) and/or physical activity specific outcome, such as physical activity self-efficacy.
Results: Five studies met the inclusion criteria. Studies were widely heterogeneous with respect to content, delivery characteristics, and outcomes, although all utilised behavioural change principles. Four studies examined interventions in which physical activity was a component of a multifaceted intervention, where depth of physical activity specific content 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. 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.
Conclusion: The efficacy of self-management programs in increasing physical activity levels in community-dwelling adults following ABI is still unknown. However, promising results indicate further examination of self-management programs specifically aimed at improving physical activity after ABI, including those utilising remote delivery, is warranted.

Key Practice Points:
•Self-management programs appear to have a favourable effect on physical activity after stroke, however efficacy cannot be established.
•Self-management programs delivered remotely warrants further investigation.
•Depth of physical activity specific content in multifaceted programs was unclear.