Community-based exercise program, self-reported health-related symptoms, and quality of life in persons with traumatic brain injury 45 + years old

Article type: Research Article

Authors: Vargas, Gary O.^a | Neaves, Stephanie^{a; b} | Pham, Tri^c | Huang, Mu^{d; e} | Turki, Ahmad Fawzi^{f; g; h} | Wang, Chaoweiⁱ | Bell, Kathleen R.^a | Juengst, Shannon B.^{a; j} | Zhang, Rong^{k; l} | Li, Mingⁱ | Driver, Simon^m | Behbehani, Khosrow^f | Hynan, Linda S.^{n; o} | Ding, Kan^{h; *}

Affiliations: [a] Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA | [b] Perot Foundation Neuroscience Translational Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA | [c] University of Texas Southwestern Medical School, Dallas, TX, USA | [d] Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA | [e] Office of Science, Medicine, and Health, American Heart Association, Dallas, TX, USA | [f] Department of Bioengineering, University of Arlington, Arlington, TX, USA | [g] Electrical and Computer Engineering Department (ECE), King Abdulaziz University, Jeddah, Saudi Arabia | [h] Center of Excellence in Intelligent Engineering Systems (CEIES), King Abdulaziz University, Jeddah, Saudi Arabia | [i] Department of Computer Science, University of Arlington, Arlington, TX, USA | [j] Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA | [k] Cerebrovascular Laboratory, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA | [l] Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA | [m] Traumatic Brain Injury Research, Baylor Scott and White Research Institute, Dallas, Texas, USA | [n] Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA | [o] Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

Correspondence: [*] Address for correspondence: Kan Ding, M.D. Department of Neurology UT Southwestern Medical Center Dallas, TX 75239, USA. E-mail: [email protected]

Abstract: BACKGROUND: Individuals with moderate to severe traumatic brain injury (msTBI) have reported a lack of motivation, lack of time, and fatigue as perceived barriers to exercise. OBJECTIVE: To evaluate the effects of an exercise program on self-reported health-related symptoms and quality of life in persons 45-years and older with msTBI. METHODS:Post-hoc analysis of a prospective community-based 12-week exercise program of 20 adults, age 45–80 years, with msTBI. Ten were in aerobic exercise training (AET) program and 10 in a stretching and toning (SAT) program. The AET group was instructed to exercise based on their estimated maximal heart rate (HR) for 150 minutes weekly. The SAT group was to stretch for the same target time without significantly increasing HR or level of exertion. Outcome measures were Traumatic Brain Injury Quality of Life (TBI-QOL) for global, cognitive, emotional, and social health, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, and Pittsburgh Sleep Quality Index (PSQI) for sleep quality. RESULTS:AET was associated with improved self-reported cognitive health and sleep compared to SAT. Moderate to large, positive effect sizes were also observed in the AET group in the QOL categories of global, emotional, and social health, and depressive symptoms. CONCLUSIONS:This study offers preliminary evidence that AET may improve health-related QOL, especially for cognition and sleep, in middle-aged and older adults with msTBI.

Keywords: Traumatic brain injury, exercise, quality of life, sleep, cognition

DOI: 10.3233/NRE-230223

Journal: NeuroRehabilitation, vol. 54, no. 3, pp. 373-381, 2024