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



      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).


      Cross-sectional cohort study.


      Outpatient brain injury clinic.


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


      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.


      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).


      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.


      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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