Impact of Return-to-Exercise on Traumatic Brain Injury Recovery in a Community Setting
Edward Weldon1, Ryan Nakamura1, Tracy Van2, Ana Nakamura3, Chancen Law4, Connor Goo1, Meliza Roman1, Enrique Carrazana5, Jason Viereck5, Kore Liow1
1University of Hawaii, John A. Burns School of Medicine, 2University of Colorado, Aurora, 3University of California, Santa Barbara, 4Kamehameha Schools Kapālama High School, 5Hawaii Pacific Neuroscience
Objective:
To investigate the relationship between exercise modalities, intensities, and patterns following TBI and recovery, and to identify health inequities and barriers to recovery that may negatively impact recovery.
Background:
Recommendations on return-to-exercise post-traumatic brain injury (TBI) remain controversial. This study surveyed Hawaii’s diverse population to identify trends in exercise and recovery for TBI patients to shape recommendations on return-to-exercise. This study also aimed to identify health inequities and factors contributing to different outcomes, allowing inequities to be addressed.
Design/Methods:
Retrospective review of 100 patients diagnosed with TBI between January 2020 and January 2022 was performed. Variables collected include demographics, etiologies, and symptoms at diagnosis. Self-generated phone surveys were completed to evaluate exercise patterns post-TBI and barriers to recovery. Statistical analysis was performed using RStudio.
Results:
Patients who recovered within two years displayed similar exercise patterns to patients who took longer than two years. Exercise frequency, intensity, and duration did not differ significantly (p=0.75, p=0.51, p=0.80, respectively). Hiking/walking for exercise was more common in the long recovery group (p=0.018), likely reflecting advanced age compared to the short recovery group (50 vs. 39 years old, p=0.003). Otherwise, exercise modalities did not differ significantly. Additionally, no correlation exists between exercise intensity and symptom change (p=0.920), suggesting patients exhibit exercise patterns suitable for their specific condition. Finally, when comparing TBI recovery resources accessed across races or insurance types, Caucasian patients and individuals with private insurance utilized the most resources (p=0.032).
Conclusions:
Return-to-exercise does not appear to be a predictor for TBI recovery. If encouraged to exercise post-TBI, patients will self-regulate a regimen not likely exacerbating their symptoms or recovery time, thus it may be suitable to recommend return-to-exercise as tolerated. The study also found worrying inequitable trends in TBI recovery resources accessed, and these disparities should be further investigated to rectify this issue.