Skip to main content Accessibility help
×
Home

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

  • Kelly M. Clanchy (a1), Sean M. Tweedy (a2) and Stewart G. Trost (a3) (a4)

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.

Copyright

Corresponding author

Address for correspondence: Dr Kelly Clanchy, School of Allied Health Sciences, Griffith University, Southport, Queensland 4215, Australia. E-mail: k.clanchy@griffith.edu.au

References

Hide All
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.
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. 113129). Philadelphia: Lippincott Williams and Wilkins.
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), 371383.
Blair, S.N., Dunn, A., Marcus, B., Carpenter, R., & Jaret, P. (2001). Active living every day. Champaign, IL: Human Kinetics.
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), 181189.
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, 7987.
Bouton, M.E. (2000). A learning theory perspective on lapse, relapse, and the maintenance of behaviour change. Health Psychology, 19 (1), 5763.
Bundy, C. (2004). Changing behaviour: Using motivational interviewing techniques. Journal of the Royal Society of Medicine, 97 (44), 4347.
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), 407413.
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.
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), 854865.
Department of Health Social Services and Public Safety. (2011). Physical activity guidelines for adults (19-64 years). Belfast: Author.
Department of Health. (2014). Australia's physical activity and sedentary behaviour guidelines. Canberra, Australia: Australian Government.
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.
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), s21s35.
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), 398412.
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), 327335.
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), 113118.
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, 822830.
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, 113.
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), 10691077.
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), 223231.
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), 4250.
Kendall, E., Buys, N., & Larner, J. (2000). Community-based service delivery in rehabilitation: The promise and the paradox. Disability and Rehabilitation, 22 (10), 435445.
Khan, F., Baguley, I.J., & Cameron, I.D. (2003). Rehabilitation after traumatic brain injury. The Medical Journal of Australia, 178, 290295.
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), s221s237.
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.
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: 2138.
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, 219229.
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), 11571165.
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), 99104.
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), 3241.
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. 3637). Champaign, IL: Human Kinetics.
Marcus, B.H., & Simkin, L.R. (1993). The stages of exercise behaviour. Journal of Sports Medicine and Physical Fitness, 33, 8388.
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, 16371640.
Miller, W.R., & Rollnick, S. (2002). Motivational interviewing and preparing people for change (2nd ed.). New York: Guilford Press.
Nampiaparampil, D.E. (2008). Prevalence of chronic pain after traumatic brain injury: A systematic review. Journal of the American Medical Association, 300 (6), 711719.
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), 402407.
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), 23032305.
Prochaska, J.O., & Velicer, W.F. (1997). The transtheoretical model of health behaviour change. American Journal of Health Promotion, 12 (1), 3848.
Reavenall, S., & Blake, H. (2010). Determinants of physical activity participation following traumatic brain injury. International Journal of Therapy and Rehabilitation, 17 (7), 360369.
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), 495502.
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), 10871095.
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, 249263.
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): 3442.
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), 419425.
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), 2229.
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, 814.
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): 753764.
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), 20642089.
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), 609613.
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), 989997.
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), 13431351.
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. 255269). Oxford: Oxford University Press.
U.S. Department of Health and Human Services. (2008a). 2008 physical activity guidelines for Americans. Washington, D.C: Department of Health and Human Services.
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. 172). Washington, D.C: Department of Health and Human Services.
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): 96100.
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), 798808.
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), 437442.
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, 13191323.
World Health Organisation. (2001). International classification of functioning, disability and health. Geneva: Author.
World Health Organisation. (2018). Global Action Plan on Physical Activity 2018–2030.
Worthington, A., & Wood, R.L. (2018). Apathy following traumatic brain injury: A review. Neuropsychologia, 118 (Part B): 4047.

Keywords

Type Description Title
WORD
Supplementary materials

Clanchy et al. supplementary material
Clanchy et al. supplementary material 1

 Word (157 KB)
157 KB
WORD
Supplementary materials

Clanchy et al. supplementary material
Clanchy et al. supplementary material 2

 Word (14 KB)
14 KB

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

  • Kelly M. Clanchy (a1), Sean M. Tweedy (a2) and Stewart G. Trost (a3) (a4)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed