The effect of physical activity on health outcomes in people with moderate-to-severe traumatic brain injury: a rapid systematic review with meta-analysis

Abstract

Background In 2020, the World Health Organization (WHO) released the first global physical activity and sedentary behaviour guidelines for children and adults living with disability. The evidence informing the guidelines though is not specific to people living with traumatic brain injury (TBI), but rather comes from other disabling conditions such as Parkinson’s disease, and stroke. There remains a clear lack of direct evidence of the effects of physical activity for people living with TBI. The objective of this rapid review was to identify direct evidence of the effect of physical activity on health outcomes in people with moderate-to-severe TBI to inform adaptation of the WHO physical activity guidelines into clinical practice guidelines. Methods We conducted a rapid systematic review with meta-analysis of randomised controlled trials, including people of any age with moderate-to-severe TBI, investigating physical activity interventions compared to either usual care, a physical activity intervention with different parameters, or a non-physical activity intervention. Four databases (CENTRAL, SPORTDiscus, PEDro, Ovid MEDLINE) were searched from inception to October 8, 2021. The primary outcomes were physical function, cognition, and quality of life. Results Twenty-three studies were included incorporating 812 participants (36% females, majority working-age adults, time post-TBI in studies ranged from 56 days (median) to 16.6 years (mean)). A range of physical activity interventions were evaluated in rehabilitation (n = 12 studies), community (n = 8) and home (n = 3) settings. We pooled data from the end of the intervention for eight outcomes. Participation in a virtual reality physical activity intervention improved mobility, assessed by the Community Balance and Mobility Scale (range 0 to 96; higher score indicates better mobility) more than standard balance training (two studies, 80 participants, Mean Difference = 2.78, 95% CI 1.40 to 4.16; low certainty evidence). There was uncertainty of effect for the remaining outcomes, limited by small sample sizes, diverse comparators and a wide range of outcome measures. Conclusion This review consolidates the current evidence base for the prescription of physical activity for people with moderate-to-severe TBI. There remains a pressing need for further rigorous research in order to develop practice guidelines to support clinical decision-making when prescribing physical activity in this population.

Using Programmable Device Installations to Control Students with Disabilities after Blast Traumatic Brain Injury in 10 Meter Walking Test

“…Physical activity is considered by experts as a powerful means of nonpharmacological recovery after blast TBI (Physical Activity Guidelines for Traumatic Brain Injury; Fulk & Nirider, 2014;Blavt, O., Galamanzhuk, L., Huska, M., et al (2024). Using Programmable Device Installations to Control Students with Disabilities after Blast Traumatic Brain Injury in 10 Meter Walking Test Johnson et al, 2023), control, as proven (Bland et al, 2011;Fure et al, 2021), having an exploratory and evaluative nature, is the basis of evidence-based rehabilitation The need for such studies is due to the lack of randomized trials establishing the effectiveness of rehabilitation after blast TBI (Xiang et al, 2022). Tests that use the function of walking are quite widespread in the practice of monitoring the rehabilitation process in persons with amputations (Brooks et al, 2001), cardiovascular diseases (Bellet et al, 2012;Hanson et al, 2012;Casillas et al, 2013), with total hip arthroplasty (Yuksel, Unver, Kalkan, & Karatosun, 2021), brain injuries (SCIRE-PROJECT), in muscular dystrophy (Pizzato et al, 2016), in neurological diseases (Tyson & Connell, 2009) and even in children, during their development (de Baptista, et al, 2020).…”

Using hypnotic suggestion in the rehabilitation of working memory capacity after acquired brain injury: study protocol for a randomized controlled trial

“…Rehabilitation efforts to improve high-level cognitive functioning following ABI have yielded limited clinically relevant effects so far [ 11 – 13 ]. Despite repeated administrations, reviews of biological interventions such as pharmaceuticals [ 14 ], noninvasive brain stimulation [ 15 ], physical exercise [ 16 ], and nutrition [ 17 ] show effect sizes in the zero to moderate range. Mindfulness can potentially reduce ABI-related fatigue.…”

Intervention-Induced Changes in Balance and Task-Dependent Neural Activity in Adults with Acquired Brain Injury: A Pilot Randomized Control Trial

“…Notably, balance impairment may be a result of decreased brain function and physical changes in movement, strength, and range of motion (i.e., paresis), leading to postural instability. In those with ABI, physical activity interventions have been used to improve postural stability during balance [10]. Hatha yoga is a physical activity intervention used to improve balance in adults with chronic stroke [11], TBI [12], and ABI [13].…”