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

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

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?

Study Overview

• Status: Recruiting
• Conditions: Traumatic Brain Injury
• Intervention / Treatment: Behavioral: GetUp&Go; Behavioral: GetUp&Go with 10-Week Delay

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.

• Study Type: Interventional
• Enrollment (Estimated): 70
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Amanda Rabinowitz, PhD; Phone Number: 215 663-6526; Email: amanda.rabinowitz@jefferson.edu
• Study Contact Backup: Name: Lauren Krasucki, DPT, MPH; Email: lauren.krasucki@jefferson.edu

Study Locations

• United States
  • Pennsylvania
    • Elkins Park, Pennsylvania, United States, 19027
      • Recruiting
      • Moss Rehabilitation Research Institute
      • Contact: Amanda Rabinowitz, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Immediate Treatment; The 10-week GetUp&Go intervention will be delivered entirely remotely, with 2 weekly sessions with a therapist delivered over videoconference (Zoom for Healthcare) followed by 3 sessions in weeks 3, 5, and 8, over Zoom or phone according to participant preference. The overall goal of the intervention is to develop and support a personalized plan to increase physical activity and decrease sedentary behavior, in concert with the unique capabilities, opportunities, and motivational factors of each participant. In session 2 and thereafter, RehaBot will be supplied to participants to deliver therapeutic ingredients to supplement those provided by the therapist.	Behavioral: GetUp&Go; A behavioral treatment combining personalized activity planning and a mobile health application for supporting adherence to activity plans.
Placebo Comparator: Waitlist; A 10-week waitlist with baseline and outcome assessment, followed by receipt of the full GetUp&Go program.	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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Average activity counts/minute	Actigraphy derived average activity counts/minute from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	Baseline
Average activity counts/minute	Actigraphy derived average activity counts/minute from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	10 weeks after initial randomization
Average activity counts/minute	Actigraphy derived average activity counts/minute from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	10 weeks after completing GetUp&Go intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percent (%) time sedentary	Actigraphy derived percent time sedentary from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	Baseline
Percent (%) time sedentary	Actigraphy derived percent time sedentary from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	10 weeks after initial randomization
Percent (%) time sedentary	Actigraphy derived percent time sedentary from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	10 weeks after completing GetUp&Go intervention
Percent (%) time engaged in moderate-vigorous physical activity (MVPA)	Actigraphy derived percent time engaged in MVPA from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	Baseline
Percent (%) time engaged in moderate-vigorous physical activity (MVPA)	Actigraphy derived percent time engaged in MVPA from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	10 weeks after initial randomization
Percent (%) time engaged in moderate-vigorous physical activity (MVPA)	Actigraphy derived percent time engaged in MVPA from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	10 weeks after completing GetUp&Go intervention
Average daily step count	Actigraphy derived average daily step count from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	Baseline
Average daily step count	Actigraphy derived average daily step count from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	10 weeks after initial randomization
Average daily step count	Actigraphy derived average daily step count from wrist-worn Actigraph GT3XP averaged over 4 consecutive-wear days over a 7-day period	10 weeks after completing GetUp&Go intervention
Self-reported PA	Physical Activity Scale for Individuals with Physical Disabilities (Scale: 0-100, where higher scores indicate a greater level of activity)	Baseline
Self-reported PA	Physical Activity Scale for Individuals with Physical Disabilities (Scale: 0-100, where higher scores indicate a greater level of activity)	10 weeks after initial randomization
Self-reported PA	Physical Activity Scale for Individuals with Physical Disabilities (Scale: 0-100, where higher scores indicate a greater level of activity)	10 weeks after completing GetUp&Go intervention
Emotional function	Brief Symptom Inventory-18 (Scale: 0-72, where higher scores indicate the presence of more psychiatric symptoms)	Baseline
Emotional function	Brief Symptom Inventory-18 (Scale: 0-72, where higher scores indicate the presence of more psychiatric symptoms)	10 weeks after initial randomization
Emotional function	Brief Symptom Inventory-18 (Scale: 0-72, where higher scores indicate the presence of more psychiatric symptoms)	10 weeks after completing GetUp&Go intervention
Fatigue	Fatigue Severity Scale Short Form (Scale: 9-63, where higher scores indicate greater fatigue)	Baseline
Fatigue	Fatigue Severity Scale Short Form (Scale: 9-63, where higher scores indicate greater fatigue)	10 weeks after initial randomization
Fatigue	Fatigue Severity Scale Short Form (Scale: 9-63, where higher scores indicate greater fatigue)	10 weeks after completing GetUp&Go intervention
Sleep Quality	Pittsburgh Sleep Quality Index (Scale: 0-21, where higher scores indicate poorer sleep quality)	Baseline
Sleep Quality	Pittsburgh Sleep Quality Index (Scale: 0-21, where higher scores indicate poorer sleep quality)	10 weeks after initial randomization
Sleep Quality	Pittsburgh Sleep Quality Index (Scale: 0-21, where higher scores indicate poorer sleep quality)	10 weeks after completing GetUp&Go intervention
Subjective pain	Brief Pain Interference Scale (Scale: 6-30, where higher scores indicate greater pain interference)	Baseline
Subjective pain	Brief Pain Interference Scale (Scale: 6-30, where higher scores indicate greater pain interference)	10 weeks after initial randomization
Subjective pain	Brief Pain Interference Scale (Scale: 6-30, where higher scores indicate greater pain interference)	10 weeks after completing GetUp&Go intervention
Health-related Quality of Life	Quality of Life after Brain Injury Scale (Scale: 0-100, where higher scores indicate better quality of life)	Baseline
Health-related Quality of Life	Quality of Life after Brain Injury Scale (Scale: 0-100, where higher scores indicate better quality of life)	10 weeks after initial randomization
Health-related Quality of Life	Quality of Life after Brain Injury Scale (Scale: 0-100, where higher scores indicate better quality of life)	10 weeks after completing GetUp&Go intervention

Collaborators and Investigators

• Sponsor: Albert Einstein Healthcare Network
• Collaborators: National Institute on Disability, Independent Living, and Rehabilitation Research
• Investigators: Principal Investigator: Amanda Rabinowitz, PhD, Albert Einstein Healthcare Network

Study record dates

Study Major Dates

• Study Start (Actual): December 19, 2023
• Primary Completion (Estimated): April 30, 2027
• Study Completion (Estimated): August 31, 2027

Study Registration Dates

• First Submitted: March 2, 2023
• First Submitted That Met QC Criteria: August 31, 2023
• First Posted (Actual): September 8, 2023

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: March 18, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: physical activity; mobile health
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Wounds and Injuries; Craniocerebral Trauma; Trauma, Nervous System; Brain Injuries, Traumatic; Brain Injuries
• Other Study ID Numbers: iRISID-2023-1533

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

All data collected for this trial will be submitted the Federal Interagency Traumatic Brain Injury Research (FITBIR) informatics system.

The data submitted to FITBIR will be fully de-identified and contain the Global Unique Identifier (GUID). The investigators will assign GUIDs to cases using the methodology recommended by FITBIR. If it is not possible to assign a GUID to cases, a Pseudo-GUID will be assigned. All variables will be converted to the TBI Common Data Elements (CDEs), to the extent possible; otherwise variables that do not map to the TBI CDEs will be submitted as Unique Data Elements (UDEs).

• IPD Sharing Time Frame: All data from this trial will be submitted to FITBIR within one year of the completion of the award, per the FITBIR submission schedule for clinical trials.

IPD Sharing Access Criteria

Projects must be specified for research purposes only (not commercial) with the intention to enhance knowledge for the benefit of human health.

Individuals requesting access must have a medical or scientific degree or position relevant for the request.

Individuals must be affiliated with a research, industry, or non-profit institution/business/organization.

All data access requests must be signed by an individual legally authorized to sign on behalf of the institution/business/organization.

• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No