Healthy Lifestyles Program for Adults with an Acquired Brain Injury.

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Brain injury is defined as “an injury to the brain which results in deterioration of cognitive, physical, emotional or independent functioning (Fortune & Wen, 1999).” Acquired brain injuries (ABI) can occur as a result of trauma, hypoxia, infection, tumour, substance abuse, degenerative neurological disease or stroke. The incidence of ABI in Australia is estimated to range between 100 and 377 per 100,000 individuals per year (Fortune & Wen, 1999). The consequences ABI, together with its relatively high prevalence, make it a disorder of major public health significant in Australia. Physical activity (PA) is defined as “any bodily movement produced by skeletal muscle contracture that increases energy expenditure.” Evidence indicates that PA reduces the risk of all-cause and cardiovascular mortality, and of coronary heart disease, obesity, hypertension, breast and colon cancer, and diabetes mellitus in particular. Physical activity has also been linked to improvements in mental health and is important for the health of muscles, bones and joints (U.S. Department of Health and Human Services, 1996). Based on this evidence, the US Surgeon General recommends that: - Significant health benefits can be obtained by including a moderate amount of PA (e.g., 30 minutes of brisk walking or raking leaves, 15 minutes of running, or 45 minutes of playing volleyball) on most, if not all, days of the week; - Additional health benefits can be gained through greater amounts of PA. People who can maintain a regular regimen of activity that is of longer duration or of more vigorous intensity are likely to derive greater benefit. Currently there is a paucity of evidence regarding PA participation by adults with an ABI. Gordon (1998) reported that, in a sample of 717 people (430 with an ABI and 287 non-disabled), 14.9% of people with an ABI self-reported exercising three times per week for the past six months, compared with 23.0% of people without a disability (Gordon, et al., 1998). It is proposed that people with a disability can also benefit from a physically active lifestyle due secondary health problems and functional limitations that could be prevented or reduced (Cooper, et al., 1999; J. A. Rimmer, et al., 1996) Due to these factors the promotion of PA in adults with an ABI has become a public health priority (Cooper, et al., 1999; J. A. Rimmer, et al., 1996). To date, there have been no studies evaluating the efficacy of a community based intervention for the promotion of PA in adults with an ABI. This study aims to evaluate the efficacy of a novel, stage matched; community based intervention for; increasing habitual physical activity (HPA) counts (measured by the ActiGraph); increasing time spent in moderate intensity PA and; decreasing time spent sedentary in adults with an ABI. The second aim of this study is to evaluate whether the novel stage matched, community based intervention increases; perceived health related quality of life; stage of change (motivational readiness); decisional balance; self efficacy and social support in adults with an ABI. Finally this study aims to qualitatively evaluate the participants and parents/guardians perceived effectiveness and acceptability of a stage matched, community based intervention. In order to evaluate the efficacy of this intervention, the intervention will be compared to a health behaviour intervention comprising of oral health, sun safety and sleep.

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