Feasibility and Acceptability Of An Outdoor Walking-Group Intervention For Adults With Moderate-To-Severe Traumatic Brain Injury

Abstract

Research Objectives Promoting physical activity (PA) after moderate-to-severe traumatic brain injury (TBI) is challenging due to elevated PA barriers (e.g., transportation, accessibility, endurance, self-consciousness) and COVID-19-related restrictions leading to the closure of community fitness centres. There was a need to create an outdoor walking-groups to promote PA participation. Study objectives were to determine the feasibility and acceptability of an outdoor walking-group intervention for adults with moderate-to-severe TBI. Design Mixed-method feasibility study. Setting Community-based outdoor setting during COVID-19. Participants Convenience sample of 18 adults (10 male, 8 female) with moderate-to-severe TBI recruited from a community TBI association. Interventions 6-week walking intervention (60-90-minutes, 2 days per week) with progressively increased walking intensity and telehealth supports (e.g., Zoom meetings, social media page). Main Outcome Measures Feasibility outcomes included program participation, attrition, and safety. Acceptability outcomes included a program satisfaction scale and supplemental qualitative data about program experiences collected through 30-60-minute semi-structured Zoom-facilitated interviews. Results 15/18 (83%) study participants completed ≥ 9 sessions (75%). Two participants were lost to attrition, and one for unrelated medical reasons. No major adverse events were reported. Minor adverse events included fatigue and muscle soreness. All participants reported high satisfaction with the intervention (M = 9.2/10, SD = 0.9) and would recommend the walking group to others. Thematic analyses of the transcribed audio recordings identified three major themes about Program Resources, Program Delivery, and Program Efficacy. Results may be used to optimize the program for the future. Conclusions A 6-week walking-group intervention is feasible and acceptable for adults with moderate-to-severe TBI. Outcomes support the development, implementation, and evaluation of formalized walking-group interventions in the community after moderate-to-severe TBI. Implications for using PA to improve health outcomes after moderate-to-severe TBI are discussed. Author(s) Disclosures Authors have no conflicts of interest to disclose. Promoting physical activity (PA) after moderate-to-severe traumatic brain injury (TBI) is challenging due to elevated PA barriers (e.g., transportation, accessibility, endurance, self-consciousness) and COVID-19-related restrictions leading to the closure of community fitness centres. There was a need to create an outdoor walking-groups to promote PA participation. Study objectives were to determine the feasibility and acceptability of an outdoor walking-group intervention for adults with moderate-to-severe TBI. Mixed-method feasibility study. Community-based outdoor setting during COVID-19. Convenience sample of 18 adults (10 male, 8 female) with moderate-to-severe TBI recruited from a community TBI association. 6-week walking intervention (60-90-minutes, 2 days per week) with progressively increased walking intensity and telehealth supports (e.g., Zoom meetings, social media page). Feasibility outcomes included program participation, attrition, and safety. Acceptability outcomes included a program satisfaction scale and supplemental qualitative data about program experiences collected through 30-60-minute semi-structured Zoom-facilitated interviews. 15/18 (83%) study participants completed ≥ 9 sessions (75%). Two participants were lost to attrition, and one for unrelated medical reasons. No major adverse events were reported. Minor adverse events included fatigue and muscle soreness. All participants reported high satisfaction with the intervention (M = 9.2/10, SD = 0.9) and would recommend the walking group to others. Thematic analyses of the transcribed audio recordings identified three major themes about Program Resources, Program Delivery, and Program Efficacy. Results may be used to optimize the program for the future. A 6-week walking-group intervention is feasible and acceptable for adults with moderate-to-severe TBI. Outcomes support the development, implementation, and evaluation of formalized walking-group interventions in the community after moderate-to-severe TBI. Implications for using PA to improve health outcomes after moderate-to-severe TBI are discussed.