# Exercise for People with Acquired Brain Injury: An ICF Perspective
## 2 Materials and Methods
### Procedure  
All the participants were informed of the purpose and methodology of the study, and, after providing written consent, they were sent the designed questionnaire via email by the responsible researcher, including a link with an online form. After completing the questionnaire, the data were stored. The responses were anonymous. **Phase 1: Selection of key parameters**  
The key parameters selected are a checklist of criteria based on the ICF, created by exercise and ABI experts, which includes the heterogeneity of four deficit areas that are targeted after ABI and how they can be influenced in different environments [19; 44; 45; 46; 47]. In this regard, the selection of key parameters was based on the subjective and objective parameter of the ABI approach. Regarding mental function (b1), the following factors were assessed: attentional processes, executive functions, reaction speed, distraction, disinhibition, limitation in dual tasks, lack of initiative, hard time understanding complex orders, and orientation problems [48; 49; 4]. In sensory functions and pain (b2), the assessed factors were as follows: hearing problems and visual deficits, and the level of detection, discrimination, location, and recognition [38]. In the voice and speech function domain (b3), the following were assessed: aphasia and apraxia speech disorders and dysarthria due to muscle weakness [50; 51]. Medical reports that include cardiac or other pathologies are necessary to understand the impact of these domains on the functions of the 1) cardiovascular, hematological, immunological, and respiratory systems (b4); 2) digestive, metabolic, and endocrine systems (b5); and 3) genitourinary and reproductive systems (b6) in exercise practice. The neuromusculoskeletal and movement-related function domain includes hypertonia and hypotonia [52; 53], hemiparesis, hemiplegia [54], ataxia [55], and motor apraxia [56]. Finally, the domain containing functions of the skin and related structures includes lack of sensitivity or hypersensitivity to pain [57]. As a result of key parameters selection, a checklist of items was develop. In line with this, Table 1 shows the selected items taking into account ICF body function and structure domains. \begin{table}
\begin{tabular}{l} \hline \hline
**Mental Function (b1)** \\ \hline Increase time required for execution of movements \\ Establish progression in the performance of dual tasks \\ Simplify task or progressively increase the number of rules to be assimilated \\ Design exercises or tasks involving both motor and cognitive actions \\ Select global-specific or specific-global method according to the cognitive deficits \\ Vary the use of methodological resources (game, exercise, circuit) \\ \hline
**Sensory Functions and Pain (b2)** \\ \hline Perform pain-free movement \\ Use bright colors and varied shapes \\ Select material locations according to deficits and using auditory or visual references \\ Regulate sounds and noises before hyperacusis \\ \hline
**Voice and Speech Function (b3)** \\ \hline Use visual elements through body expression, pictograms, or images \\ Use brief explanations, concise feedback, and positive reinforcement during task \\ Establish keywords that facilitate technical-user communication \\ Simplify task or progressively increase the number of rules to be assimilated \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Checklist Body Function. Related to limitations and participation restrictions domains, an exercise professional with experience in ABI approach selects the most adequate type of exercise for each person so that he or she can achieve the highest participation rate. In this regard, work on self-esteem serves to improve participation [58] so that the person with ABI chooses to perform activities in an exercise group rather than individually whenever possible [59]. These choices will determine the success of the design and implementation of an exercise program for ABI [47,60] (Table 2).