Effect of Immersion Therapy delivered by an Accredited Exercise Physiologist on physical and psychosocial recovery following traumatic injury when transitioning from hospital inpatient to outpatient care

The study proposes to use a mixed model design including a randomised controlled trial (RCT) design for both quantitative and qualitative (self-report) outcomes and then to conduct qualitative semi-structured interviews with a representative sub-group of participants. The RCT will use a wait-list control whereby participants are randomised to receive 16 weeks of IT immediately upon enrolment or after a 16 week wait. Outcome measures will be assessed at weeks 0, 16 and 32 allowing the RCT comparison as well as a non-randomised crossover analysis (in wait-listed participants) and a single group prospective 16 week follow up (in intervention group). The intervention will be the standard Immersion Therapy (IT) service model delivered by accredited IT Specialists (who are also Accredited Exercise Physiologists). IT is an underwater experience for people living with injury, chronic illness and/or disability, TBI, SCI, as well as chronic pain, mental illness, and developmental and degenerative disorders. Using scuba equipment (a buoyancy control device and regulator or full-face mask) in a two-to-five-metre deep pool environment, clients can swim, walk, play or relax, completely immersed. IT does not aim to teach clients to dive recreationally but utilizes scuba as a form of ‘therapy’, aiming to exert its effects, either through physical movement underwater and/or the psychosocial experience. Participants will be introduced to the service at their own pace in accordance with existing protocols and given complete independence in designing their service in collaboration with their clinician. The treating clinicians will liaise with other service providers as appropriate to ensure the service can complement the person’s rehabilitation goals. Participants will be asked to attend at least 1 and up to 2 session per week for 16 weeks with each session lasting up to 45 minutes. Sessions will be conducted in a one-on-one format, with participant attendance recorded through the service provider’s (Determined2) existing booking system. Attendance will be monitored weekly by the service provider’s Operations Manager to ensure adherence. The IT will take place at The Parks Recreation & Sports Centre, 46 Cowan Street, Angle Park, SA. Semi-structured, one-on-one interviews will be conducted by a member of research team either face-to-face or via video conferencing and at take 45 to 60 minutes. All participants that have completed the IT program will be invited to participate in the interviews until the sample size is sufficient that novel data become so infrequent that further interviews are unlikely to meaningfully alter the results. Interviews will be audio recorded with participant consent and transcribed using a professional transcription service.