Self-management in neurological disorders: a scoping review of behavior change theories, strategies, contents, and impact.

Abstract

This scoping review aimed to identify and map the behavior change theories, behavior change techniques (BCTs), and effectiveness of self-management (SM) interventions designed to improve functioning outcomes in persons with neurological conditions (NDs). Following the PRISMA-ScR guidelines and the Arksey and O'Malley framework, a systematic search of PubMed, Web of Science, CINAHL, and PsycInfo was conducted. From 2,568 screened records, 18 studies met the inclusion criteria. Quantitative study characteristics were descriptively summarized, and deductive thematic analysis using the BCT Taxonomy (v1) was applied to identify and classify behavior change theories and techniques. Included studies covered stroke (<i>n</i> = 9), spinal cord injury (<i>n</i> = 4), multiple sclerosis (<i>n</i> = 3), mixed neurological populations (<i>n</i> = 1), and Parkinson's disease (<i>n</i> = 1), predominantly from high-income countries. Social Cognitive Theory and Self-Determination Theory were the most frequently applied frameworks. The five most utilized BCTs were problem solving, action planning, information about health consequences, goal setting, and self-monitoring of behavior. Despite heterogeneity in BCT combinations, outcome measures, dosage, and delivery modes, functioning improvements were consistently reported. SM interventions grounded in established behavior change theories demonstrate consistent preliminary benefits for functioning in neurological rehabilitation, supporting a shift toward patient-centered, participatory, and sustainable models of care.