GetUp&Go: A Randomized Controlled Trial of an Intervention to Enhance Physical Activity After TBI

Official title

GetUp&Go: A Randomized Controlled Trial of a Theory-Based Intervention to Enhance Physical Activity in Chronic, Moderate-Severe Traumatic Brain Injury

Overview

The goal of this clinical trial is to evaluate GetUp\&Go, a program for promoting increased physical activity in individuals at least 6 months post moderate-to-severe traumatic brain injury. GetUp\&Go is a remotely delivered 10-week program that includes one-on-one sessions with a therapist and a mobile health application (RehaBot). The main question is whether participants in the 10-week GetUp\&Go program increase their physical activity, and exhibit associated benefits in mental and physical health, relative to those who are put on a waitlist. * Question 1: Do participants who receive immediate treatment with GetUp\&Go show more increased physical activity, measured by accelerometer activity counts per day, and improve more on secondary outcomes, such as self-reported physical activity, emotional function, fatigue, sleep, pain, and health-related quality of life, compared to their baseline, relative to those who are put on a waitlist? * Question 2: Do participants who have continued access to the mobile health component of the intervention, RehaBot, show better maintenance of physical activity gains compared to those who no longer have access to RehaBot? * Question 3: Are individual participant characteristics associated with participants' response to the treatment program?

Detailed description

The investigators will conduct a Randomized Controlled Trial (RCT) of a novel, remotely delivered physical activity (PA) promotion program, called GetUp\&Go-a name selected by focus group participants with moderate-to-severe traumatic brain injury (msTBI). It will be theoretically based, use objective measurement of PA as a primary outcome, and incorporate varied types and amounts of home- and neighborhood-based PA and ways to reduce sedentary behavior, according to participant preferences. Moreover, using a 2-phase design as described below, the investigators will test a method for enhancing longer-term gains in PA using mobile technology, in addition to gains acquired during the first phase of intervention.

Trial design. Participants will undergo baseline testing (T1) and will then be randomized 1:1 to either immediate treatment in GetUp\&Go (IT) or waitlist (WL) for 10 weeks. After testing for the primary outcome (T2), the waitlist group will receive GetUp\&Go for 10 weeks followed by a T2b evaluation for that group. This phase is called the "A phase", for Acquisition.

Following completion of the GetUp\&Go intervention, all participants-regardless of initial group allocation-will be randomized 1:1 to one of two conditions for an additional 10 weeks, the "Follow-Through" (FT) phase. Half of participants will be randomized to the RehaBot condition (RB), which provides continued use of the chatbot to support individualized PA plans, but with no further therapist contact. Participants in the No RehaBot (No RB) condition will not have access to the chatbot. The final evaluation, T3, will occur after the 10-week Follow-Through phase.

Interventions

• Behavioral GetUp&Go
  A behavioral treatment combining personalized activity planning and a mobile health application for supporting adherence to activity plans.
• Behavioral GetUp&Go with 10-Week Delay
  No assigned treatment during the waitlist phase. Participants in the WL group will be offered the GetUp\&Go intervention, which combines personalized activity planning and a mobile health application, after collection of the primary outcome measure.

Primary outcome measures

• Average activity counts/minute [Time frame: Baseline]
• Average activity counts/minute [Time frame: 10 weeks after initial randomization]
• Average activity counts/minute [Time frame: 10 weeks after completing GetUp&Go intervention]

Secondary outcome measures (12)

• Percent (%) time sedentary [Time frame: Baseline]
• Percent (%) time sedentary [Time frame: 10 weeks after initial randomization]
• Percent (%) time sedentary [Time frame: 10 weeks after completing GetUp&Go intervention]
• Percent (%) time engaged in moderate-vigorous physical activity (MVPA) [Time frame: Baseline]
• Percent (%) time engaged in moderate-vigorous physical activity (MVPA) [Time frame: 10 weeks after initial randomization]
• Percent (%) time engaged in moderate-vigorous physical activity (MVPA) [Time frame: 10 weeks after completing GetUp&Go intervention]
• Average daily step count [Time frame: Baseline]
• Average daily step count [Time frame: 10 weeks after initial randomization]
• Average daily step count [Time frame: 10 weeks after completing GetUp&Go intervention]
• Self-reported PA [Time frame: Baseline]
• Self-reported PA [Time frame: 10 weeks after initial randomization]
• Self-reported PA [Time frame: 10 weeks after completing GetUp&Go intervention]

Eligibility criteria

Inclusion criteria

• Age ≥18
• TBI (open or closed), sustained at least 6 months prior to enrollment, of at least complicated-mild/moderate severity as evidenced by loss or alteration of consciousness ≥ 30 minutes; and/or post-traumatic amnesia (PTA) ≥ 24 hours, not due to intoxication/sedation and documented prospectively from the injury; and/or positive neuroimaging findings consistent with TBI
• Fully weight bearing on lower limbs and able to walk indoors and outdoors without the assistance of another person
• Cognitively able to participate in treatment as judged by ability to travel independently within the community
• Able to communicate adequately in English for participation in the treatment protocols
• Informed consent given by participant

Exclusion criteria

• Contraindications to increasing PA as judged by study physician, using an exam based on published screening tools
• Medical or psychiatric instability, including current psychosis or severe uncontrolled substance misuse, as assessed using items from the SCID/MINI/ASSIST, or suicidal ideation with intent or plan, as assessed by the Columbia-Suicide Severity Rating Scale, screening version
• Significant physical or intellectual disability predating the TBI
• Neurodegenerative disorder, e.g., Parkinson's disease
• Insufficiently inactive, i.e., reporting > 23 weekly moderate/vigorous activity units on the Godin Leisure-Time Exercise Questionnaire
• Planned surgery or other hospitalization during the succeeding 9 months
• Physical or sensory disability (e.g., blindness; severe bimanual incoordination) that prevents use of a smartphone

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

United States · 1 center

• Moss Rehabilitation Research Institute — Elkins Park

Publications

• Hart T, Vaccaro M, Krasucki L, Chervoneva I, Rabinowitz A. Increasing physical activity in moderate-severe traumatic brain injury: protocol for a two-stage randomized controlled trial of a remote, mHealth-enhanced intervention. Front Rehabil Sci. 2026 Feb 2;7:1656326. doi: 10.3389/fresc.2026.1656326. eCollection 2026. PMID 41705067

Identifiers

NCT: NCT06028334 · iRISID-2023-1533

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗