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To determine the cross-sectional and temporal relationships between minutes per week of moderate to vigorous physical activity (MVPA) as measured by a wrist-worn accelerometer and secondary conditions in the first year after moderate to severe traumatic brain injury (TBI). Prospective longitudinal cohort study. Four inpatient rehabilitation centers. Individuals (N = 180) with moderate-severe TBI enrolled in the TBI Model Systems Study. Participants wore a wrist accelerometer for 7 days immediately post discharge, and for 7 consecutive days at 6- and 12-months post injury. Minutes per week of MVPA from daily averages based on wrist worn accelerometer. Secondary conditions included depression (Patient Health Questionnaire-9), fatigue (PROMIS Fatigue), Pain (Numeric Rating Scale), Sleep (Pittsburgh Sleep Quality Index), and cognition (Brief Test of Adult Cognition by Telephone). At baseline, 6 and 12 months, 61%, 70% and 79% of the sample achieved at least 150 minutes per week of MVPA. The correlations between minutes of MVPA between baseline, 6 and 12 months were significant (r = 0.53-0.73), as were secondary conditions over these time points. However, no significant correlations were observed between minutes of MVPA and any secondary outcomes cross-sectionally or longitudinally at any time point. Given the robust relationships physical activity has with outcomes in the general population, further research is needed to understand the effect of physical activity in individuals with moderate-severe TBI. [ABSTRACT FROM AUTHOR]

To describe the process of partnering with stakeholders in a six-year systematic line of research to modify an evidence-based weight-loss program called the Diabetes Prevention Program Group Lifestyle Balance (DPP-GLB) for individuals with individuals with TBI and stroke. Commentary from two patient stakeholders will be included. Narrative Review. Community. Stakeholders (former patients, care partners, physiatrists, researchers, therapists, neuropsychologists, exercise specialists, dietitians, community partners, and DPP-GLB coaches). Not applicable. Not applicable. The DPP-GLB modification process involved three phases: (1) engaging stakeholders to identify appropriate adaptations to the DPP-GLB, (2) making relevant modifications to create the GLB-CVA and GLB-TBI, and (3) obtaining approval from the stakeholders that modifications accurately reflect their recommendations. Engagement was sustained through (1) piloting research surveys, (2) providing guidance on eligibility criteria and outcome assessments, (3) testing mobile applications, (4) reviewing factsheets for usability, (5) attending quarterly meetings, and (6) informing future grant applications. Stakeholder perspectives have been critically important to ensuring study goals and project activities are meaningful and patient-centered. Our stakeholders helped create a more health literate (e.g., factsheets, modified curriculum), patient-centered (e.g., including peer mentors and care partners), and meaningful program for people with TBI and stroke, which would not have been possible with our research team alone. he contents of this abstract were developed under two grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant numbers 90DPTB0013 and 90IFRE0021). NIDILRR is a center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this abstract do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government. [ABSTRACT FROM AUTHOR]

To describe engagement with stakeholders (n=37), including children and young adults, to identify common issues surrounding sport related concussion (SRC) screening, diagnosis, and treatment. Narrative Review. Community. Stakeholders were divided into two groups: Patients-Parents-Coaches (middle, high school, college athletes, parents, coaches) and Professionals (athletic trainers, school administrators, medical professionals, policymakers). Patient centered outcomes research (PCOR) engagement principles (reciprocal relationships, co-learning, partnerships, and trust, transparency, and honesty) were used as a framework for engagement. Strategies include 1) virtual monthly stakeholder meetings, 2) follow-up survey to evaluate teaching methods, satisfaction with engagement, and opportunities for improvement, and 3) dissemination of meeting materials post-meeting. Attendance and stakeholder feedback. On average, attendance was 69% and engagement survey completion was 70%. Stakeholders indicated the virtual meeting platform was convenient and they felt important and part of a process to help others. Common SRC issues included the need for validated sideline assessments, increased awareness of specialized SRC care, and how to best inform and educate patients to promote autonomy over their treatment plan. Middle and high school athletes indicated their primary goal was to return to sport as soon as possible after SRC, while parents expressed concern about possible short- and long-term effects and the benefits and risks of continued sport participation after SRC recovery. Although ongoing, this project has convened an engaged group of stakeholders in meaningful discussion on issues related to SRC screening, diagnosis, and treatment. By partnering with stakeholders, we will identify shared PCOR priorities for SRC research. This abstract was funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award EACB 24236. [ABSTRACT FROM AUTHOR]

To describe the clinical implications of wearing a mask among special populations in inpatient rehabilitation. Narrative Review. Inpatient rehabilitation. Patients undergoing acute inpatient rehabilitation. Mask wearing. Effect of mask wearing on exercise outcomes, including perceived exertion, shortness of breath, and patient perception; clinical implications for the interdisciplinary team. Five trials which observed exercise outcomes after mask wearing were identified and summarized. Findings for the effect of face masks on exercise and vital signs varied due to heterogeneity of exercise protocols and outcome measures. Relevant findings show that patients who wore masks had higher ratings of perceived exertion, increased shortness of breath, and feelings of claustrophobia while wearing a face mask during exercise. Wearing masks affected physical and mental outcomes despite exercise intensity (low, moderate, or high). Moderate-to-high intensity exercise is needed for neuroplasticity. This type of exercise may not be possible in neurological populations, who do not have normal oxygen consumption at rest or with exercise, and may be further affected by wearing masks. Clinicians should their patients' mask wearing into consideration, and change the frequency, intensity, timing and types of exercises when patients are wearing a face mask. Frequent measurement of vital signs and fatigue symptoms are critical to maintain patient safety, and adjustments should be made as necessary. Other neurological challenges to monitor include impaired cognitive function, limited communication, reduced mood, and interactions with medications. These can affect the patients' ability to accurately determine and state their perceived effort or may hinder physiological and autonomic responses. Lastly, interdisciplinary teams should communicate patient findings related to mask wearing at team conferences, huddles and include discussion for ways to increase patients' participation and how to optimize health outcomes. None. [ABSTRACT FROM AUTHOR]

No clinical guidelines exist for the delivery of robotic exoskeleton gait training (RGT) during inpatient rehabilitation. Our purpose was to modify a RGT intervention with input from an Advisory Board (AB) of stakeholders to meet the unique needs of individuals with spinal cord injury (SCI) during inpatient rehabilitation. Community-Based Participatory Research. Virtual meeting. AB comprised 12 invitees (5 individuals with SCI lived experience, 2 physicians, 1 rehabilitation psychologist, 3 robotic exoskeleton-certified physical therapists and 1 robotic exoskeleton industry representative) and 9 research team members. AB members engaged in small break-out and large group discussions over a 3-hour virtual meeting. Participants were given structured prompts and open-ended questions to review prior to meeting. Research team members recorded the meeting and documented feedback on suggested RGT modifications. Stakeholders were contacted as needed following the meeting for clarification and iterative decision-making. Qualitative responses about 1) Inclusion/exclusion criteria, 2) Clinical application and dosage of RGT, 3) Outcome measures, and 4) Engagement and Recruitment. Feedback from AB included: 1) expand inclusion criteria for those aged 16 to 70 years, 2) include co-existing mild/uncomplicated traumatic brain injury, 3) afford opportunities for patients to engage with clinical team regarding pros/cons to participating in RGT, 4) aim for 90 minutes/week of RGT, but allow for individual flexibility determined by patient tolerance and therapeutic priorities, and 5) assess affective outcomes in addition to gait and mobility performance. AB feedback provided keen insight for developing an RGT intervention for inpatients with SCI. Future research efforts should examine the efficacy and effectiveness of the adapted intervention amidst ongoing stakeholder engagement. The authors have nothing to disclose. [ABSTRACT FROM AUTHOR]