An Exploratory CFIR-Informed Process Evaluation Utilizing Data from a Pilot Randomized Controlled Trial of a
Kelly Krese1,2, Mary McNulty3, Catherine Justice4
1Doctor of Physical Therapy Program, Midwestern University, Downers Grove, Illinois, USA.
Journal of Integrative and Complementary Medicine
|July 22, 2026
Summary
Implementing yoga-based physical therapy for traumatic brain injury (TBI) survivors faced barriers like time constraints and scope ambiguities. Facilitators included strong organizational support and interdisciplinary collaboration in acute rehabilitation.
Area of Science:
- Rehabilitation Medicine
- Implementation Science
- Neuroscience
Background:
- Traumatic brain injury (TBI) rehabilitation often requires innovative therapeutic approaches.
- Yoga-based physical therapy (PT) shows promise for improving physical and cognitive function post-TBI.
- Implementing new interventions in acute inpatient settings presents unique challenges.
Purpose of the Study:
- To evaluate the implementation of a yoga-based group PT intervention for TBI patients using the Consolidated Framework for Implementation Research (CFIR).
- To identify implementation determinants (barriers and facilitators) influencing intervention delivery.
- To describe strategies used to overcome identified implementation barriers.
Main Methods:
- A CFIR-informed process evaluation nested within a randomized controlled feasibility trial.
- Data collected from meeting minutes of interdisciplinary clinical and research team meetings.
- Analysis focused on implementation determinants mapped to CFIR domains and patient-specific barriers.
Main Results:
- Facilitators included organizational support, interdisciplinary communication, and collaboration.
- Barriers identified were time demands, cultural factors, and professional scope ambiguities.
- Patient-specific physical and cognitive-behavioral participation barriers were also documented.
Conclusions:
- Contextual, organizational, and professional factors significantly influence yoga-based PT implementation in TBI rehabilitation.
- Findings are exploratory, offering insights for future research on optimizing yoga intervention integration.
- This study informs strategies for enhancing the sustainability of yoga-based interventions in early TBI recovery.
