Objective To assess traumatic brain injury knowledge levels in Australia. Design A cross-sectional study using the modified Common Misconceptions about Traumatic Brain Injury questionnaire to assess knowledge of traumatic brain injury. Setting Data were collected from Australians enrolled in the Understanding Traumatic Brain Injury Massive Open Online Course between August 2023 and March 2025. Participants A total of 1484 respondents with varying educational backgrounds, caregiving experience, lived experience of traumatic brain injury, and prior traumatic brain injury education. Main measures Knowledge was assessed across three domains: Perceptions of concussion , Emotional and behavioral changes , and Recovery after traumatic brain injury . Scores were compared across demographic, educational, caregiving, or lived experience groups. Results Greater knowledge was associated with prior traumatic brain injury education, tertiary qualifications, paid caregiving roles, or English-speaking backgrounds. Across all groups, knowledge was highest for Perceptions of concussion and lowest for Recovery after traumatic brain injury . Knowledge also differed by experience, where individuals with lived experience demonstrated lower knowledge scores, whereas those who knew someone with a traumatic brain injury demonstrated higher scores. Conclusions The limited knowledge of recovery after traumatic brain injury observed in this Australian cohort aligns with international evidence demonstrating persistent misconceptions about recovery and long-term outcomes. These findings suggest that recovery-related knowledge gaps are a global issue that may affect help-seeking, care navigation, and rehabilitation engagement, highlighting the need for targeted educational initiatives worldwide.
Objective To describe the experience of pain among people with Parkinson's disease, including its characteristics, psychological effects, and impact on daily life. Design Qualitative descriptive study. Setting Community-based study using semi-structured individual interviews. Participants Fifteen people with Parkinson's disease (11 women) diagnosed according to the United Kingdom Parkinson's Disease Society Brain Bank criteria and experiencing Parkinson's disease-related pain based on the Parkinson's Disease Pain Classification System. Intervention Not applicable. Main measures Semi-structured interviews were conducted to explore participants’ experiences of pain. Data were analysed using an inductive thematic analysis based on a hybrid approach combining artificial intelligence-powered coding through ChatGPT-4 with manual triangulation. Results Three main themes were identified: (1) experiences and perceptions of pain, including the nature and characterization of pain and its relationship with Parkinson's disease; (2) the impact of pain on daily life; and (3) feelings associated with pain, including emotional changes related to pain and its broader psychological impact. Conclusions Pain in people with Parkinson's disease is an interconnected and context-dependent experience extending beyond its physical manifestations. The patient-centred narratives provide contextual insight into how pain interacts with motor and non-motor symptoms, daily functioning, emotional well-being, and participation, supporting individualized and comprehensive approaches to pain assessment and management.
Objective To understand the perspectives of clinicians and researchers on the nature of safer mobility behaviour and how it is applied to fall prevention in people with Parkinson's disease. Design A qualitative study using focus group discussions with reflexive thematic analysis. Setting An international cohort participated in the study online via video conference. Participants Nineteen physiotherapists, occupational therapists and/or researchers (median 18 years of experience) were included across five focus groups. Results Empowerment was the central theme underpinning the promotion of safer mobility behaviour. Empowerment meant enabling people towards safe, effective and meaningful task engagement. This was embedded across three sub-themes. Firstly, a contextual approach was needed to understand the complex nature of mobility behaviour involving the combination of physical, cognitive, psychological and Parkinson's disease (e.g. disease progression and fluctuations) related influences. Secondly, an individual approach was needed to provide a holistic assessment evaluating the impact of these influences as well as tailoring interventions to address them. Thirdly, a collaborative approach was needed between clinicians, individuals and care-partners to ensure shared problem solving and goal setting. Conclusions A novel approach to fall prevention was described in this study. It recognised a person's autonomy and dignity of risk through a balanced consideration of safety during meaningful activities. It also highlighted the role of expert clinicians to work alongside individuals and care-partners for safer strategy development. This study provides the foundation for the development and implementation of safer mobility behaviour strategies for fall prevention in people with Parkinson's disease.
Objective This study aimed to compare the effects of mirror therapy delivered through different media on upper limb and hand motor recovery in stroke patients using a network meta-analysis. Data sources Five electronic databases were searched from inception to 7 September 2026. Review methods Methodological quality was assessed using the Cochrane risk-of-bias tool (RoB 2.0). A Bayesian framework was applied for network meta-analysis, and evidence quality was evaluated using the Grading of Recommendations Assessment, Development and Evaluation. Results Thirty trials involving 1212 participants were included, covering three mirror therapy modalities. Network meta-analysis showed that, compared with control group, virtual reality-based mirror therapy (mean difference [MD] = 8.75; 95% credible interval [CrI]: 4.56 to 13.30), digital screen-based mirror therapy (MD = 6.95; 95% CrI: 3.18 to 10.48), and traditional mirror therapy (MD = 5.29; 95% CrI: 2.58 to 7.70) significantly improved upper limb motor function. For hand motor function, virtual reality-based mirror therapy was superior to the control group (MD = 4.65; 95% CrI: 1.06 to 8.16) and traditional mirror therapy (MD = 3.77; 95% CrI: 0.54 to 7.14). Virtual reality-based mirror therapy consistently ranked as the most effective intervention. The certainty of evidence ranged from very low to moderate. Conclusion Virtual reality-based mirror therapy showed the most favourable exploratory effect estimates, but the relative efficacy of different delivery media remains uncertain because most comparisons were indirect and the certainty of evidence for hand motor function was very low. Head-to-head trials are needed to confirm these findings.
Objective To examine the associations between the frequency of moderate–vigorous physical activity and depression among adults aged 50 years or older with a history of stroke. Design and setting Cross-sectional study using data from Wave 9 (2021–2022) of the Survey of Health, Aging and Retirement in Europe. Participants A total of 1323 adults aged 50 years or older with a history of stroke, residing in 18 European countries, were included. Analysis Binary logistic regression models were used to examine associations between the weekly frequency of moderate–vigorous physical activity and depression. Analyses were stratified by sex and adjusted for potential confounders. Main measurements Depression was assessed using the 12-item European Depression Scale. Weekly moderate–vigorous physical activity frequency was categorized as <1 time per week, 1 time per week, or >1 time per week. Results Adjusted results showed that, for men, engaging in moderate physical activity once (odds ratio = 0.60) or more than once a week (odds ratio = 0.49) reduced the odds of depression. For vigorous physical activity, the benefit in men required a frequency of more than once a week (odds ratio = 0.61). Among women, moderate–vigorous physical activity significantly reduced the risk of depression only when performed more than once a week (odds ratio = 0.58 and 0.43, respectively). Conclusion In individuals aged 50 or older with a history of stroke, the weekly frequency of moderate–vigorous physical activity was associated with lower odds of depression in both sexes. However, the benefits of this association vary by sex.
