LoveYourBrain Mindset: Feasibility, Acceptability, Usability, and Effectiveness of an Online Yoga, Mindfulness, and Psychoeducation Intervention for People with Traumatic Brain Injury.

OBJECTIVE: Despite the benefits of yoga, mindfulness, and psychoeducation after traumatic brain injury (TBI), no online programming exists. This study investigated the feasibility, acceptability, usability, and effectiveness of the LoveYourBrain Mindset online program for people with TBI. RESEARCH DESIGN: Pre-post, retrospective intervention. METHODS: LoveYourBrain Mindset is a six-week online yoga, mindfulness, and psychoeducation program with weekly interactive Zoom classes and prerecorded mindfulness tools. Two interactive class types (45-minute group discussion, 75-minute group discussion and gentle yoga) are offered to enhance accessibility. People were eligible if they experienced TBI, were a caregiver, or clinician; ≥15 years old; and capable of gentle exercise and group discussion. We analyzed attendance, program ratings, mindfulness tools utilization, and pre/post-intervention differences in QOL, resilience, emotional/behavioral dysregulation, cognition, and positive affect/well-being. RESULTS: Overall, 1539 individuals signed up for LoveYourBrain Mindset with 1093 (71.02%) participating in one/more classes. The mean program rating was 9.09 (SD=1.28). Majority (62.99%) used the mindfulness tools each week. Multiple linear regression models controlling for age, TBI severity, and gender indicated significant improvements in QOL, resilience, emotional/behavioral dysregulation, cognition, and positive affect/well-being (p<0.001). CONCLUSION: LoveYourBrain Mindset is feasible, acceptable, usable, and may improve outcomes among people with TBI.

The feasibility, acceptability, and effectiveness of the multimodal, community-based LoveYourBrain Retreat program for people with traumatic brain injury and caregivers.

PURPOSE: To evaluate the feasibility, acceptability, and effectiveness of the LoveYourBrain Retreat program using a pre-post, retrospective, concurrent triangulation mixed methods study. MATERIALS AND METHODS: A 5-day, multimodal, residential Retreat intervention was designed to improve quality of life among traumatic brain injury (TBI) survivors and caregivers through mindfulness, movement, nutrition, art, and community-building. Eligibility included being a TBI survivor (>2 years post-injury) or caregiver, 18+ years old, independently mobile, able to communicate verbally, and a first-time participant. Self-reported quantitative and qualitative data were collected via electronic surveys pre- and post-retreat, analyzed separately, then combined. Paired t-tests assessed mean differences in scores on Quality of Life After Brain Injury Overall scale (QOLIBRI-OS) and NIH TBI/Neuro-QOL Resilience, Cognition, Positive Affect/Wellbeing, and Emotional/Behavioral Dysregulation scales. We assessed feasibility using sample characteristics and program frequency and retention, and acceptability using quality ratings. Content analysis explored perceived benefits and improvements. RESULTS: 68 People-53 with TBI and 15 caregivers-participated in one of three LoveYourBrain Retreats. Significant improvements were found in QOLIBRI-OS (6.91, 95%CI 1.88-11.94), Resilience (2.14, 95%CI 0.50-3.78), Cognition (2.81, 95%CI 0.79-4.83), and Emotional/Behavioral Dysregulation (2.84, 95%CI 0.14-5.54) among TBI survivors (n = 41). Mean satisfaction was 9.6/10 (SD = 0.64). Content analysis revealed community connection, reframing TBI experience, self-regulation, and self-care themes. CONCLUSIONS: The LoveYourBrain Retreat is feasible, acceptable, and may be effective complementary rehabilitation to improve QOL among TBI survivors.

Ongoing, holistic rehabilitation services are critical to quality of life for people with chronic traumatic brain injury (TBI).Residential retreats are a type of holistic, multimodal, community-based rehabilitation.LoveYourBrain Retreats improved quality of life, resilience, cognition, and emotional dysregulation among people with TBI.The integration of community connection, reframing TBI experience, self-regulation, and self-care may support adjustment to TBI.

Best Practices for Adapting and Delivering Community-Based Yoga for People with Traumatic Brain Injury in the United States and Canada.

Emerging benefits of yoga for traumatic brain injury (TBI) suggest that broader accessibility to community-based yoga programming is important. This cross-sectional, mixed methods study sought to identify best practices for adapting and delivering community-based yoga to people with TBI. An online survey was sent to 175 yoga teachers trained to teach LoveYourBrain Yoga, a community-based, 6-week, manualized program for people with TBI and their care-givers. The survey instrument included open- and closed-text questions assessing teachers' perspectives on the most and least helpful adaptions for asana, meditation, pranayama, and group discussion, and on the LoveYourBrain Yoga training and support. Responses we re analyzed using d e s c r i p t i ve statistics and qualitative content analysis. Eighty-six teachers (50%) responded. Best practices for adapting yoga for TBI revealed six themes: (1) simple, slow, and repeated; (2) creating a safe space; (3) position of the head and neck; (4) demonstration; (5) importance of props; and (6) special considerations for yoga studios. Three themes emerged for yoga program delivery: (1) structured yet flexible; (2) acceptability of compensation; and (3) time management. Eighty-nine percent of teachers reported that the program manual was very/extremely helpful, yet nearly half (49%) adapted the manual content often/always. To deliver community-based yoga services for TBI, we recommend an environment with props, low light and noise, and sufficient space, along with the facilitation of consistent instruction with a manual that allows for flexibility. We recommend that yoga teachers have skills in physical modifications for the head and neck; slow, simple, and repeated cueing to facilitate cognitive processing; managing challenging behaviors through redirection techniques; and promoting safety through inclusivity, compassion, and personal agency.