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The Adapted Physical Activity Program: A Theory-Driven, Evidence-Based Physical Activity Intervention for People with Brain Impairment

Published online by Cambridge University Press:  05 November 2018

Kelly M. Clanchy ,
Sean M. Tweedy  and
Stewart G. Trost
Kelly M. Clanchy*
Affiliation:
School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia
Sean M. Tweedy
Affiliation:
School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
Stewart G. Trost
Affiliation:
School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia Institute of Health and Biomedical Innovation, Queensland University of Technology - Centre for Children's Health Research, Brisbane, Queensland, Australia
*
Address for correspondence: Dr Kelly Clanchy, School of Allied Health Sciences, Griffith University, Southport, Queensland 4215, Australia. E-mail: k.clanchy@griffith.edu.au
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Abstract

People with brain impairments are less active than the general population and consequently have an increased risk of chronic disease. To increase activity requires interventions that are theory driven and evidence based. Here, we describe the adapted physical activity program (APAP), a physical activity promotion program with demonstrated efficacy in community dwelling adults with brain impairments. Distinguishing features of the APAP include the following: delivery in the participants home/or community environment and the utilisation of the principals of community-based rehabilitation; the assessment of each of the domains of the International Classification of Functioning, Disability and Health (ICF) (i.e., health conditions, impairments, activity limitations, participation restrictions and personal and environmental characteristics) to determine how they will impact physical activity adoption and maintenance; the incorporation of theory-based physical activity adoption and maintenance strategies; the utilisation of lifestyle physical activity programs (including client-centred selection of activities) and/or structured exercise programs (requiring principles of exercise prescription). It is anticipated that this program description will permit researchers and/or practitioners to implement the program, replicate its evaluation and/or translate the program into multi-professional rehabilitation settings.

Keywords

brain impairmentphysical activityhealth promotion
Type
Protocols
Information
Brain Impairment , Volume 20 , Issue 1 , March 2019 , pp. 81 - 95
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2018 

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References

American College of Sports Medicine (2010). General principles of exercise prescription. In Thompson, W.R., Gordon, N.F., & Pescatello, L.S. (Eds.), ACSM's guidelines for exercise testing and prescription (8th ed.). Philadelphia: Lippincott Williams & Wilkins.Google Scholar
Bhambani, Y. (2010). Traumatic brain injury. In Myers, J., Nieman, D., & (Eds.), ACSM's resources for clinical exercise physiology: musculoskeletal, neuromuscular, neoplastic, immunologic and hematologic conditions (2nd ed., pp. 113–129). Philadelphia: Lippincott Williams and Wilkins.Google Scholar
Binkley, J.M., Stratford, P.W., Lott, S.A., & Riddle, D.L. (1999). The lower extremity functional scale (LEFS): Scale development, measurement properties, and clinical application. Physical Therapy, 79 (4), 371–383.Google Scholar
Blair, S.N., Dunn, A., Marcus, B., Carpenter, R., & Jaret, P. (2001). Active living every day. Champaign, IL: Human Kinetics.Google Scholar
Blissmer, B., & McAuley, E. (2002). Testing the requirements of stages of physical activity among adults: The comparative effectiveness of stage-matched, mismatched, standard care and control interventions. Annals of Behavioural Medicine, 24 (3), 181–189.Google Scholar
Bock, B.C., Marcus, B.H., Pinto, B.M., & Forsyth, L.A.H. (2001). Maintenance of physical activity following an individualized motivationally tailored intervention. Annals of Behavioural Medicine, 23, 79–87.Google Scholar
Bouton, M.E. (2000). A learning theory perspective on lapse, relapse, and the maintenance of behaviour change. Health Psychology, 19 (1), 57–63.Google Scholar
Bundy, C. (2004). Changing behaviour: Using motivational interviewing techniques. Journal of the Royal Society of Medicine, 97 (44), 43–47.Google Scholar
Carroll, D.D., Courtney-Long, E.A., Stevens, A.C., Sloan, M.L., Lullo, C., Visser, S.N., . . . Centers for Disease Control and Prevention. (2014). Vital signs: Disability and physical activity–United States, 2009–2012. Morbidity and Mortality Weekly Report (MMWR), 63 (18), 407–413.Google Scholar
Casperson, C.J., Powell, K.E., & Christenson, G.M. (1985). Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research. Public Health Reports, 100 (2), 126.Google Scholar
Clanchy, K., Tweedy, S.M., & Trost, S.G. (2016). Evaluation of a physical activity intervention for adults with brain impairment: A controlled clinical trial. Neurorehabilitation and Neural Repair, 30 (9), 854–865.Google Scholar
Department of Health Social Services and Public Safety. (2011). Physical activity guidelines for adults (19-64 years). Belfast: Author.Google Scholar
Department of Health. (2014). Australia's physical activity and sedentary behaviour guidelines. Canberra, Australia: Australian Government.Google Scholar
DiClemente, C.C., & Velasquez, M.M. (2002). Motivational interviewing and the stages of change. In Miller, W.R. & Rollnick, S. (Eds.), Motivational interviewing: Preparing people for change (2nd ed.). New York: The Guilford Press.Google Scholar
Dijkers, M. (2004). Quality of life after traumatic brain injury: A review of research approaches and findings. Archives of Physical Medicine and Rehabilitation, 85 (Suppl 2), s21–s35.Google Scholar
Dunn, A.L., Andersen, R.E., & Jakicic, J.M. (1998). Lifestyle physical activity interventions: History, short- and long-term effects, and recommendations. American Journal of Preventive Medicine, 15 (4), 398–412.Google Scholar
Dunn, A.L., Marcus, B.H., Kampert, J.B., Garcia, M.E., Kohl, H.W., & Blair, S.N. (1999). Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness. A randomized trial. Journal of the American Medical Association, 281 (4), 327–335.Google Scholar
Eng, J.J., Dawson, A.S., & Chu, K. (2004). Submaximal exercise in individuals with stroke: Test-retest reliability and concurrent validity with VO2max. Archives of Physical Medicine and Rehabilitation, 85 (1), 113–118.Google Scholar
Gillham, S., & Endacott, R. (2010). Impact of enhanced secondary prevention on health behaviour in patients following minor stroke and transient ischaemic attack: A randomized controlled trial. Clinical Rehabilitation, 24, 822–830.Google Scholar
Haskell, W.L., Lee, I.-M., Pate, R.R., Powell, K.E., Blair, S.N., Franklin, B.A., . . . Bauman, A. (2007). Physical activity and public health: Updated recommendation for adults from the American college of sports medicine and the American Heart association. Circulation, 116, 1–13.Google Scholar
Hassett, L.M., Harmer, A.R., Moseley, A.M., & Mackey, M.G. (2007). Validity of the modified 20-metre shuttle test: Assessment of cardiorespiratory fitness in people who have sustained a traumatic brain injury. Brain Injury, 21 (10), 1069–1077.Google Scholar
Heller, T., Ying, G.S., Rimmer, J.H., & Marks, B.A. (2002). Determinants of exercise in adults with cerebral palsy. Public Health Nursing, 19 (3), 223–231.Google Scholar
Jorge, R.E., Robinson, R.G., Moser, D., Tateno, A., Crespo-Facorro, B., & Arndt, S. (2004). Major depression following traumatic brain injury. Archives of General Psychiatry, 61 (1), 42–50.Google Scholar
Kendall, E., Buys, N., & Larner, J. (2000). Community-based service delivery in rehabilitation: The promise and the paradox. Disability and Rehabilitation, 22 (10), 435–445.Google Scholar
Khan, F., Baguley, I.J., & Cameron, I.D. (2003). Rehabilitation after traumatic brain injury. The Medical Journal of Australia, 178, 290–295.Google Scholar
King, A.C., Blair, S.N., Bild, D.E., Dishman, R.K., Dubbert, P.M., Marcus, B.H., . . . Yeager, K.K. (1992). Determinants of physical activity and interventions in adults. Medicine and Science in Sports and Exercise, 24 (6), s221–s237.Google Scholar
Kohl, H.W., & Murray, T.D. (2012). Part II: Health effects of exercise and physical activity. In Foundations of physical activity and public health. Champaign, IL: Human Kinetics.Google Scholar
Kosma, M., Ellis, R., Cardinal, B.J., Bauer, J., & McCubbin, J. (2007). The mediating role of intention and stages of change in physical activity among adults with physical disabilities: An integrative framework. Journal of Sport and Exercise Psychology, 29: 21–38.Google Scholar
Lee, I.-M., Shiroma, E.J., Lobelo, F., Puska, F., Blair, S.N., Katzmarzyk, P.T., & The Lancet Physical Activity Series Working Group. (2012). Effects of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet, 380, 219–229.Google Scholar
LIFE Study Investigators, Pahor, M., Blair, S. N., Espeland, M., Fielding, R., Gill, T.M., . . . Studenski, S. (2007). Effects of a physical activity intervention on measures of physical performance: Results of the lifestyle interventions and independence for elders pilot (LIFE-P) study. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 61 (11), 1157–1165.Google Scholar
Littlewood, R.A., Davies, P.S.W., Cleghorn, G.J., & Grote, R.H. (2004). Physical activity cost in children following an acquired brain injury—A comparative study. Clinical Nutrition, 23 (1), 99–104.Google Scholar
Marcus, B.H., Dubbert, P.M., Forsyth, L.H., McKenzie, T.L., Stone, E.J., Dunn, A.L., & Blair, S.N. (2000). Physical activity behavior change: Issues in adoption and maintenance. Health Psychology, 19 (15), 32–41.Google Scholar
Marcus, B.H., & Forsyth, L.H. (2009). Integrating other psychological theories and models. In Marcus, B.H. & Forsyth, L.H. (Eds.), Motivating people to be physically active (pp. 36–37). Champaign, IL: Human Kinetics.Google Scholar
Marcus, B.H., & Simkin, L.R. (1993). The stages of exercise behaviour. Journal of Sports Medicine and Physical Fitness, 33, 83–88.Google Scholar
Menon, D.K., Schwab, K., Wright, D.W., Maas, A.I., & The Demographics and Clinical Assessment Working Group of the International and Interagency Initiative toward Common Data Elements for Research on Traumatic Brain Injury and Psychological Health. (2010). Position statement: Definition of traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 91, 1637–1640.Google Scholar
Miller, W.R., & Rollnick, S. (2002). Motivational interviewing and preparing people for change (2nd ed.). New York: Guilford Press.Google Scholar
Nampiaparampil, D.E. (2008). Prevalence of chronic pain after traumatic brain injury: A systematic review. Journal of the American Medical Association, 300 (6), 711–719.Google Scholar
Pate, R.R., Pratt, M., Blair, S.N., Haskell, W.L., Macera, C.A., Bouchard, C., . . . Wilmore, J.H. (1995). Physical activity and public health: A recommendation from the centers for disease control and prevention and the American college of sports medicine. The Journal of the American Medical Association, 273 (5), 402–407.Google Scholar
Peterson, M.D., Ryan, J.M., Hurvitz, E.A., & Mahmoudi, E. (2015). Chronic conditions in adults with cerebral palsy. Journal of the American Medical Association, 314 (21), 2303–2305.Google Scholar
Prochaska, J.O., & Velicer, W.F. (1997). The transtheoretical model of health behaviour change. American Journal of Health Promotion, 12 (1), 38–48.Google Scholar
Reavenall, S., & Blake, H. (2010). Determinants of physical activity participation following traumatic brain injury. International Journal of Therapy and Rehabilitation, 17 (7), 360–369.Google Scholar
Rimmer, J.H. (1999). Health promotion for people with disabilities: The emerging paradigm shift from disability prevention to prevention of secondary conditions. Physical Therapy, 79 (5), 495–502.Google Scholar
Rimmer, J.H. (2006). Use of the ICF in identifying factors that impact participation in physical activity/rehabilitation among people with disabilities. Disability and Rehabilitation, 28 (17), 1087–1095.Google Scholar
Rimmer, J.H., Chen, M.-D., McCubbin, J.A., Drum, C., & Peterson, J. (2010). Exercise intervention research on persons with disabilities: What we know and where we need to go. American Journal of Physical Medicine and Rehabilitation, 89, 249–263.Google Scholar
Rimmer, J.H., Riley, B.B., Rubin, S.S. (2001). “A New Measure for Assessing the Physical Activity Behaviors of Persons with Disabilities and Chronic Health Conditions: the Physical Activity and Disability Survey.” American Journal of Health Promotion 16 (1): 34–42.Google Scholar
Rimmer, J.H., Riley, B., Wang, E., Rauworth, A., & Jurkowski, J. (2004). Physical activity participation among persons with disabilities. Barriers and facilitators. American Journal of Preventative Medicine, 26 (5), 419–425.Google Scholar
Rimmer, J.H., Schiller, W., & Chen, M.-D. (2012). Effects of disability-associated low energy expenditure deconditioning syndrome. Exercise and Sport Sciences Reviews, 40 (1), 22–29.Google Scholar
Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., Damiano, D., . . . Jacobsson, B. (2006). A report: The definition and classification of cerebral palsy April 2006. Developmental Medicine and Child Neurology, 109, 8–14.Google Scholar
Ryan, J.M., Allen, E., Gormley, J., Hurvitz, E.A., & Peterson, M.D. (2018). The risk, burden, and management of non-communicable diseases in cerebral palsy: A scoping review. Developmental Medicine and Child Neurology, 60 (8): 753–764.Google Scholar
Sacco, R.L., Kasner, S.E., Broderick, J.P., Caplan, L.R., Connors, J.J., Culebras, A., . . . Council on Nutrition Physical Activity and Metabolism. (2013). An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American heart association/American stroke association. Stroke, 44 (7), 2064–2089.Google Scholar
Salter, K., Jutai, J., Foley, N., & Teasell, R. (2010). Clinical outcome variables scale: A retrospective validation study in patients after stroke. Journal of Rehabilitation Medicine, 42 (7), 609–613.Google Scholar
Shields, N., Synnot, A.J., & Barr, M. (2012). Perceived barriers and facilitators to physical activity for children with disability: A systematic review. British Journal of Sports Medicine, 46 (14), 989– 997.Google Scholar
Tuomilehto, J., Lindstrom, J., Eriksson, J.G., Valle, T.T., Hamalainen, H., Ilanne-Parikka, P., . . . The Finnish Diabetes Prevention Study Group. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. The New England Journal of Medicine, 344 (18), 1343–1351.Google Scholar
Tweedy, S.M. (2007). Reducing preventable health disadvantage for people with disabilities through physical activity promotion. In Taylor, S., Foster, M., & Fleming, J. (Eds.), Health policy and practice in Australia (pp. 255–269). Oxford: Oxford University Press.Google Scholar
U.S. Department of Health and Human Services. (2008a). 2008 physical activity guidelines for Americans. Washington, D.C: Department of Health and Human Services.Google Scholar
U.S. Department of Health and Human Services. (2008b). Review of the science: Health outcomes associated with physical activity in people with disabilities. In 2008 physical activity guidelines for Americans U.S. department of health and human services (pp. 1–72). Washington, D.C: Department of Health and Human Services.Google Scholar
van der Ploeg, H.P., Streppel, K.R., van der Beek, A.J., van der Woude, L.H., Vollenbroek-Hutten, M., van Mechelen, W. (2007). “The Physical Activity Scale for Individuals with Physical Disabilities: Test-Retest Reliability and Comparison with an Accelerometer.” Journal of Physical Activity and Health 4 (1): 96–100.Google Scholar
Verschuren, O., Peterson, M.D., Balemans, A.C.J., & Hurvitz, E.A. (2016). Exercise and physical activity recommendations for people with cerebral palsy. Developmental Medicine and Child Neurology, 58 (8), 798–808.Google Scholar
Williams, G., Robertson, V., Greenwood, K., Goldie, P., & Morris, M.E. (2006). The concurrent validity and responsiveness of the high-level mobility assessment tool for measuring the mobility limitations of people with traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 87 (3), 437–442.Google Scholar
Wise, E.K., Hoffman, J.M., Powell, J.M., Bombardier, C.H., & Bell, K.R. (2012). Benefits of exercise maintenance after traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 93, 1319–1323.Google Scholar
World Health Organisation. (2001). International classification of functioning, disability and health. Geneva: Author.Google Scholar
World Health Organisation. (2018). Global Action Plan on Physical Activity 2018–2030.Google Scholar
Worthington, A., & Wood, R.L. (2018). Apathy following traumatic brain injury: A review. Neuropsychologia, 118 (Part B): 40–47.Google Scholar
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