A Remotely Delivered Progressive Walking Intervention for Adults With Persistent Symptoms of a Mild Traumatic Brain Injury: Feasibility and Exploration of Its Impact.
Christophe Alarie, Isabelle Gagnon, Elaine de Guise and 4 others
PMID 36189010WHAT IT FOUND
For adults with persistent concussion symptoms, a remote progressive walking programme with coaching, monitoring and education was feasible, safe and well accepted.
Participants walked more and reported fewer symptoms, less fear of movement, less fatigue and better quality of life.
Key findings
01The remote progressive walking intervention was feasible and safe: all enrolled participants completed it, and all recorded adverse events were resolved without complications.
02Participants found the telehealth approach acceptable and would recommend it, with high agreement on the intervention, remote delivery, tools and perceived benefits.
03After the intervention, participants had more steps and lower symptom, fear-of-movement, anxiety and fatigue scores, and higher quality-of-life scores; because the study was single-group and many also received other health services, these changes cannot be attributed to walking alone.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had no control group, so changes cannot be separated from natural recovery, time, attention from weekly sessions, or other health services. Twenty participants were recruited from waitlists, and about 50% of those contacted declined, so the sample may have been unusually motivated and not representative. Most participants were women, and time since injury ranged from three months to 29 months, so results may not apply to all adults with mild TBI. Participants and research assistants knew they were receiving the walking programme, and many outcomes were self-reported, which can influence symptom ratings. The activity monitor and walking logs had accuracy and completeness problems, and no follow-up was done after the eight weeks, so durability is unknown. Exploratory outcomes were not the main feasibility question, and several changes, such as sleep and walk frequency, did not show a clear change.
Declared interests
The research and open-access fees were supported by the Fonds de Recherche du Québec en Santé. The first author received a bursary from the École de Réadaptation of the Université de Montréal. The authors declare no commercial or financial relationships that could be construed as a conflict of interest.
The easy way to misread this
Do not tell patients that this programme will reduce their symptoms. It was a small uncontrolled feasibility study, and many participants also received other health services, so the changes cannot be attributed to the walking intervention alone.