Brain pathways glowing with physical activity symbols representing neurorehabilitation.

Unlock Movement: A Guide to Physical Activity Training for Neurorehabilitation Professionals

Nico Varela in Health & Wellness July 2025 • 4 min read.

"Empowering Healthcare Providers with Behavior Change Strategies for Enhanced Patient Outcomes."

Increasing physical activity (PA) is a cornerstone of health, yet it remains a challenge, especially for individuals with neurological conditions. While the benefits of exercise for neurological rehabilitation are clear—influencing neurotrophic, neuroprotective, and disease-modifying effects—simply advising patients to be more active isn't enough.

For those with neurological disabilities, physical limitations and cognitive impairments can make regular physical activity difficult. That’s where behavior change strategies (BCS) come in, offering techniques specifically designed to address the psychological factors that influence behavior. Unfortunately, many healthcare professionals (HCPs) lack the confidence and understanding to effectively implement these strategies.

This article explores findings from a systematic review aimed at understanding the methods used to train HCPs in delivering BCS for PA promotion in neurological populations. By examining how previous behavior change intervention studies have trained HCPs, we can inform the design of future training programs and bridge the gap between knowledge and clinical implementation.

Why Behavior Change Strategies Matter in Neurorehabilitation?

Brain pathways glowing with physical activity symbols representing neurorehabilitation.

Behavior change strategies are the active components of interventions designed to modify behavior by targeting psychological determinants. In neurorehabilitation, effective strategies include tailored counseling with goal setting, planning, monitoring, and feedback. Guidelines and systematic reviews emphasize that combining PA initiatives with BCS is most effective, yet this approach is not consistently applied.

The core issue lies in equipping healthcare professionals with the right tools and knowledge. To address this, a systematic review was conducted, adhering to PRISMA guidelines, to synthesize existing literature on training HCPs to deliver BCS for PA promotion among individuals with neurological conditions.

Search Strategy: Eight databases were searched for articles describing HCP training on BCS targeting PA and/or exercise for neurological pathology.
Study Selection: Two researchers independently screened abstracts, using third-party consensus when needed. Studies had to describe the planning/implementation of BCS targeting PA in adults with neurological disorders, with interventions delivered by an HCP.
Data Extraction: A data extraction table was used, based on the study objective and the Cochrane Consumers and Communication Review Group’s template. Risk of bias was assessed using Quality Assessment Tools.
Synthesis: Data were synthesized according to a who, what, when, and how approach.

The search yielded 2,616 articles, with 13 meeting inclusion criteria, representing eight unique interventions for individuals with spinal cord injury, stroke, multiple sclerosis, and Parkinson's disease. Methodological quality varied from strong to weak, with common training features including multiple resources, sessions, expert input, and ongoing support, but a lack of training effectiveness evaluation.

Moving Forward: Enhancing Training and Implementation

The review underscores the need for improved training of HCPs in delivering BCS for physical activity promotion in neurological populations. Future research should focus on detailed descriptions of HCP training content and structure, direct measures of training effectiveness, and the integration of implementation strategies during the development and reporting of behavior change interventions. By addressing these gaps, the field can move closer to realizing the full potential of physical activity in neurorehabilitation, improving outcomes and quality of life for countless individuals.

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Everything You Need To Know

What are Behavior Change Strategies (BCS) and why are they important in the context of neurorehabilitation?

Behavior Change Strategies (BCS) are active components of interventions that are designed to modify behavior by targeting psychological determinants. In neurorehabilitation, BCS are crucial because physical limitations and cognitive impairments can make regular physical activity difficult for individuals with neurological conditions. Effective strategies include tailored counseling with goal setting, planning, monitoring, and feedback. Combining Physical Activity (PA) initiatives with BCS is most effective, but it requires healthcare professionals (HCPs) to be trained in their implementation.

What were the key findings from the systematic review regarding training HCPs in delivering BCS?

The systematic review, which adhered to PRISMA guidelines, examined how healthcare professionals (HCPs) were trained to promote physical activity (PA) using Behavior Change Strategies (BCS) among individuals with neurological conditions. The review found that common training features included multiple resources, sessions, expert input, and ongoing support. However, a significant gap was the lack of direct measures of training effectiveness. The methodological quality of the studies varied. It examined eight unique interventions for individuals with spinal cord injury, stroke, multiple sclerosis, and Parkinson's disease.

What specific neurological conditions were included in the studies reviewed, and what types of interventions were examined?

The systematic review included interventions for individuals with several neurological conditions, including spinal cord injury, stroke, multiple sclerosis, and Parkinson's disease. The interventions focused on the use of Behavior Change Strategies (BCS) to promote Physical Activity (PA). The review synthesized data based on a "who, what, when, and how" approach to understand the training provided to healthcare professionals (HCPs) in delivering these strategies.

Why is it challenging to increase physical activity for individuals with neurological conditions, and how do Behavior Change Strategies address these challenges?

Increasing physical activity (PA) is particularly challenging for individuals with neurological conditions due to physical limitations and cognitive impairments. These challenges can make it difficult to engage in regular exercise. Behavior Change Strategies (BCS) directly address these challenges by focusing on the psychological factors that influence behavior. Strategies like tailored counseling, goal setting, planning, monitoring, and feedback help individuals overcome barriers to PA, providing the support and motivation needed to become and stay active. Healthcare professionals (HCPs) trained in BCS can effectively guide and support individuals in adopting and maintaining an active lifestyle.

What are the recommendations for future research and implementation to improve physical activity promotion in neurorehabilitation?

Future research should focus on improving the training of healthcare professionals (HCPs) in delivering Behavior Change Strategies (BCS) for Physical Activity (PA) promotion. The systematic review underscored the need for more detailed descriptions of HCP training content and structure. Direct measures of training effectiveness are crucial to determine the impact of the training. Additionally, the integration of implementation strategies during the development and reporting of behavior change interventions is vital. By addressing these gaps, the field can move closer to realizing the full potential of physical activity in neurorehabilitation, improving outcomes and quality of life for individuals with neurological conditions.