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Characterizing Physical Activity and Sedentary Behavior in Adults With Persistent Postconcussive Symptoms After Mild Traumatic Brain Injury

      Abstract

      Objective

      To evaluate physical activity (PA) and sedentary behavior and their associations with symptom and quality of life outcomes in adults with persistent postconcussive symptoms (PPCS) after mild traumatic brain injury (mTBI).

      Design

      Cross-sectional cohort study.

      Setting

      Outpatient brain injury clinic.

      Participants

      Consecutive sample of adults (N=180) with a diagnosis of mTBI and PPCS.

      Interventions

      Not applicable.

      Main Outcome Measures

      PA and sedentary behavior were assessed using the Godin Leisure-Time Exercise Questionnaire and Rapid Assessment Disuse Index, respectively. Participants were dichotomized according to whether they completed 150 minutes of moderate-to-vigorous PA per week, based on Canadian guidelines. Postinjury moderate-to-vigorous PA was also analyzed as a continuous variable.

      Results

      Prior to injury, 85% of participants reported meeting PA guidelines, compared with 28% postinjury. Individuals meeting PA guidelines postinjury reported higher quality of life (η2p=0.130; P<.001) and lower scores on measures of functional impact of headache (η2p=0.065; P=.009), fatigue (η2p=0.080; P=.004), depression (η2p=0.085; P=.001), and anxiety (η2p=0.046; P=.031), compared with those not meeting guidelines. Sedentary behavior postinjury was negatively correlated with quality of life (rs[127]=–0.252; P=.004) and positively correlated with symptom burden (rs[167]=0.227; P=.003), fatigue (rs[127]=0.288; P=.001), depression (rs[174]=0.319; P<.001), and anxiety (rs[127]=0.180; P=.042).

      Conclusions

      PA was significantly decreased in individuals with PPCS compared to preinjury levels. Meeting PA guidelines postinjury was associated with better clinical outcomes, suggesting that returning individuals to PA should be considered in the treatment of this patient population.

      Keywords

      List of abbreviations:

      ANCOVA (analysis of covariance), FSS (Fatigue Severity Scale), GAD-7 (Generalized Anxiety Disorder Scale), GLTEQ (Godin Leisure-Time Physical Exercise Questionnaire), HIT-6 (Headache Impact Test), mTBI (mild traumatic brain injury), PA (physical activity), PHQ-9 (Patient Health Questionnaire), PPCS (persistent postconcussive symptoms), QOLIBRI (Quality of Life after Brain Injury questionnaire), RADI (Rapid Assessment Disuse Index), RPQ (Rivermead Post Concussion Symptoms Questionnaire), TBI (traumatic brain injury)
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