Physical Activity After Traumatic Brain Injury

Traumatic brain injury (TBI) refers to damage the from a physical force. This can include falls, car accidents, or gunshots, among other causes. TBI cause difficulties with cognition (thinking) and function (movement). More than 2.5 million Americans experience each year. Many individuals do not complete regular activity. •Physical activity is any bodily movement produced by skeletal muscles that results in expenditure of energy•Exercise planned, structured, repetitive, performed improve health fitness•The Health Human Services Physical Activity Guidelines1US Department ServicesPhysical guidelines for Americans. 2nd ed. US Services, Washington, DC2018Google Scholar provide recommendations about time intensity needed maintain well-being•The advise get at least:○150 minutes moderate (eg, walking briskly, dancing, gardening) per week OR○75 vigorous running, tennis, hiking uphill, heavy housework) AND○2 more days strength training increases release growth factors help build new cells2Wogensen E. Malá H. Mogensen J. The effects exercise on cognitive recovery after acquired animal models: systematic review.Neural Plast. 2015; 2015: 830871Google increase size,3Erickson K.I. Voss M.W. Prakash R.S. et al.Exercise size hippocampus improves memory.Proc Natl Acad Sci U S A. 2011; 108: 3017-3022Google which leads to:○Decreased memory decline4Richards M. Hardy R. Wadsworth M.E.J. Does active leisure protect cognition? Evidence national birth cohort.Soc Med. 2003; 56: 785-792Google Scholar○Improved ability make decisions5Chin L.M. Keyser R.E. Dsurney Chan L. Improved performance following aerobic people traumatic injury.Arch Phys Med Rehabil. 96: 754-759Google Scholar,6Colcombe S.J. Kramer A.F. Erickson al.Cardiovascular fitness, cortical plasticity, aging.Proc 2004; 101: 3316-3321Google Scholar○Increased processing speed, how quickly you think5Chin Scholar,7Grealy M.A. Johnson D.A. Rushton S.K. Improving injury: use virtual reality.Arch 1999; 80: 661-667Google learning memory7Grealy Scholar•Social benefits activity8Eime R.M. Young J.A. Harvey J.T. Charity M.J. Payne W.R. A review psychological social participation sport adults: informing development conceptual model through sport.Int J Behav Nutr Act. 2013; 10: 135Google life satisfaction○Decreased stress•Social group Scholar○Social interaction peers○Opportunities friendships○Increased communication skills•Physical activity○Maintain healthy weight9Swift D.L. Johannsen N.M. Lavie C.J. Earnest C.P. Church T.S. role weight loss maintenance.Prog Cardiovasc Dis. 2014; 441-447Google Scholar○Prevent falls10Kovács Sztruhár Jónásné I. Karóczi C.K. Korpos Gondos T. Effects multimodal program balance, functional mobility fall risk older adults impairment: randomized controlled single-blind study.Eur Rehabil 49: 639-648Google Scholar○Increase bone density11Jain R.K. Vokes as measured accelerometer NHANES 2005-2006 associated better density trabecular score adults.Arch Osteoporos. 2019; 14: 29Google Scholar○Improve your heart lung function12Chin L.M.K. Woolstenhulme J.G. Christensen E.J. Shenouda C.N. cardiorespiratory fitness injury.J Head Trauma 30: 382-390Google Scholar,13Hassett Moseley A.M. Harmer A.R. Fitness conditioning injury.Cochrane Database Syst Rev. 2017; 12: CD006123Google There are many reasons why may find it challenging be physically active.14Driver S. Ede Dodd Z. Stevens Warren What barriers recent face?.Disabil 2012; 5: 117-125Google Scholar,15Hassett Tate R.L. Gillett L.E. Injury severity, age pre-injury history predict adherence home-based programme injury.Brain Inj. 25: 698-706Google Table 1 identifies some potential solutions.Table 1Possible solutions overcome activityBarriers ActivityPotential SolutionsTransportation•Use public transportation ride sharing applications•Ask family friendsAccess center•Complete large room home•Go local parkCost•Find low cost free activities such brisk walking•Use resistance bands household items weightsDo know exercise•Ask certified inclusive trainer therapist•Talk doctorCognition memory•Keep consistent routine•Use planner schedule activity•Set reminders electronic devices phone•Use written step-by-step directionsPoor motivation•Find partner group•Explore what inspires motivates othersFatigue•Participate during times have energy•Start tasks home fatigue•Know limits rest breaks Open table tab key can—do when can. Even if only tolerate few time, try 2 3 day. Gradually goal 30 daily. lists example ways modify them according levelsTable 2Examples modifications.ActivitiesModificationImprove EnduranceWalkIf too easy: distanceIf hard: slow down, take shorter walks oftenBicycleIf stationary bicycle back balanceImprove Leg StrengthSquats: stand legs shoulder-width apart lower buttocks toward ground slowly before coming upIf add weights leg timeIf practice standing up chairHeel raises: tip toesIf hold wall Arm StrengthBicep curls: weighted object (such soup) hand side bring shoulder while bending elbowIf band feetIf without weightShoulder abduction: move arms away body until they parallel groundIf weightPushups: keep hands next shoulders toes floor. Push keeping straightIf number doIf put knees completing movement. You also push off wallImprove BalanceYoga, tai chi, exercisesIf close eyesIf chair poses •Consult physician unsure safely start adding into daily life•Physical therapists rehabilitation professionals who diagnose treat variety impairments health-related conditions injuries quality life•Certified trainers advanced adapt physical, sensory, disabilities •Move United (www.moveunitedsport.org/sports/adaptive-sports)•National Center Health, Disability (www.nchpad.org)•LoveYourBrain Yoga (www.loveyourbrain.com/yoga)•YMCA provides memberships sliding scale payment (www.ymca.net) page was developed Shanti Pinto, MD (e-mail address: [email protected] ); Eric Watson, PhD; Wendy Contreras, MD; Kaitlin Luffman, PT, DPT, CBIS; Mark Newman, PhD, MPH. information meant replace advice medical professional should interpreted clinical guideline. Information/Education Page reproduced noncommercial care service providers share their patients clients. Any reproduction subject approval publisher. Supported Brain Injury-Interdisciplenary Special Interest Group (BI-ISIG) Chronic Task Force.