A systematic review of the efficacy of self-management programs for improving PA in community-dwelling adults with ABI.
A literature search was conducted using five databases (PubMed, Embase, Scopus, ScienceDirect, and Web of Science). The search was limited to English-language journals published by April 2023. Additionally, hand-searching of bibliographies of relevant studies and systematic reviews was performed. The search keywords were structured using the Population, Intervention, Comparison, and Outcome (PICO) method. The inclusion criteria were studies that assessed the effects of self-management interventions aimed at enhancing PA levels or physical outcomes. Studies that also assessed other outcomes related to PA, such as self-efficacy, social support, and stages of change, were included. The self-management interventions were considered regardless of whether they were generic or specific to a health condition, provided they included at least one of the following components: problem-solving, goal setting, decision-making, self-monitoring, coping strategies, or another approach to facilitate behavior change. Studies that only included advice and/or education were excluded. Two independent reviewers conducted quality appraisals of the included studies.
Fifteen studies met the inclusion criteria. The studies varied widely in terms of program structure, content, and delivery. All studies utilized behavioral change theories and principles but differed in their outcome measures for assessing PA. Five of the included studies reported favorable outcomes for improving PA levels following self-management programs, though they had a moderate risk of bias. In terms of delivery, some studies used face-to-face approaches, while others used remote methods, mainly via phone. All interventions provided opportunities to develop decision-making skills, and some included problem-solving skills, typically in the context of managing fatigue or mitigating mobility impairments. All interventions included components related to taking action and allowed for self-tailoring.
This review provides insight into the efficacy of self-management programs for improving PA in community-dwelling adults with ABI. However, the evidence remains unclear, with insufficient support for the effectiveness of such programs. The findings are inconclusive due to the high heterogeneity of programs, outcome measures, and the moderate risk of bias in the included studies. More research is needed to determine the effectiveness of self-management programs in this population.
This review highlights the potential of self-management programs to enhance PA in community-dwelling adults with ABI. By integrating these programs into physiotherapy practice, therapists can improve patient outcomes and promote self-efficacy in rehabilitation. Further research is warranted to refine these programs and establish best clinical outcomes and patient satisfaction.
Physical Activity
Acquired Brain Injury
