Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Nov 9, 2021
Date Accepted: Feb 1, 2022
Tele-Active Rehabilitation for youth with concussion: Evidence-based and theory-informed intervention development
ABSTRACT
Background:
Active rehabilitation involving low-intensity exercise combined with education and support promotes recovery in youth with concussion but is typically delivered in-person at specialized clinics, which may limit accessibility for families due to a lack of services in their communities or logistical challenges to attending in-person sessions.
Objective:
This paper describes the evidence-based and theoretically informed development of the Tele-Active Rehabilitation intervention for pediatric concussion, specifically designed for remote service delivery.
Methods:
The intervention was designed by clinician-researchers with experience in pediatric concussion rehabilitation according to the Medical Research Council guidance for developing complex interventions. Development involved a critical review of the literature to identify existing evidence, expansion of the theoretical basis for active rehabilitation, and modelling intervention process and outcomes.
Results:
Tele-Active Rehabilitation is a 6-week home exercise and education and support program facilitated through weekly videoconferencing appointments with a clinician. Exercise consists of low-moderate intensity sub-symptom threshold aerobic activity and coordination drills individualized to participant needs and interests (prescribed for 3 days/week). Education includes the evidence-supported Concussion & You self-management program, which covers topics related to energy management, nutrition/hydration, sleep hygiene, and return to activity. Elements of Self-Determination Theory are incorporated to support motivation and engagement. We present a logic model describing predicted intervention effects using a biopsychosocial conceptualization of outcomes after concussion.
Conclusions:
The Tele-Active Rehabilitation intervention may help increase access to care that improves recovery and promotes a timely return to activities in youth with concussion. Future research is needed to evaluate the feasibility and efficacy of this approach.
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Copyright
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