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)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 24, 2021
Accepted:
May 10,
2021
Received in revised form:
April 20,
2021
Received:
January 20,
2021
Footnotes
Preliminary results presented to the 13th World Congress on Brain Injury, March 13-16, 2019, Toronto, Canada.
Disclosures: Dr Keith Owen Yeates is supported by the Ronald and Irene Ward Chair in Pediatric Brain Injury from the Alberta Children's Hospital Foundation. The other authors have nothing to disclose.
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
