Physical activity and perceived barriers in individuals with moderate‐to‐severe traumatic brain injury

Abstract

Introduction: Regular physical activity (PA), especially aerobic exercise, may benefit cognitive function in middle-aged and older adults, but promoting regular PA in individuals with traumatic brain injury (TBI) remains a challenge. Objective: To characterize PA and perceived barriers to PA in younger (<45 years) and middle age and older (≥45 years) individuals ≥1 year after moderate-to-severe TBI. Design: Multicenter survey study. Setting: Community. Participants: Persons who met the following criteria were included in the study: (1) 18 years and older; (2) English speaking; (3) History of moderate-tosevere TBI; (4) Followed in a TBI Model Systems Center for at least 1 year; and (5) Able to complete the survey independently. Intervention: Not applicable. Main Outcome Measure(s): PA level measured by Rapid Assessment of Physical Activity questionnaire (RAPA) and self-reported barriers to PA.Results: A total of 472 participants completed the survey (response rate of 21%). More individuals in the younger group (<45 years old) met Centers for Disease Control and Prevention (CDC) recommended aerobic PA guidelines compared to the middle-aged and older group (≥ 45 years old) (62% vs 36%, p < .001). Lack of motivation, lack of time, and fatigue were the most reported barriers. Perceived barriers to PA varied by age and PA level: the middle-aged and older individuals (≥ 45 years old) were more likely to report no barriers and inactive individuals (RAPA ≤5) more likely to report lack of motivation and money, pain, and lack of resources. Conclusion: Participants ≥45 years of age were less likely to meet the CDC PA guidelines than younger individuals after moderate-to-severe TBI. Because perceived barriers to PA varied between age groups and PA levels, individualized approaches may be needed to promote PA in this population.

Physical Activity Preferences of People Living with Brain Injury: Formative Qualitative Research to Develop a Discrete Choice Experiment

“…A weakness of this study is low participation of four specific groups: people aged 18–35 years, people aged 65+ years, rural community dwellers and those from culturally diverse populations. However, Pham et al [ 71 ] suggest that key differences in age groups relating to perceptions of physical activity by people living with TBI are less pronounced after 45 years of age, and Rydén et al [ 72 ] found that DCE development interviews with patients across multiple countries generally produced consistent results, thus our process may not have suffered significantly from the lack of older and culturally diverse participants. Importantly, we plan to use survey implementation strategies that target people aged 18–35 years, people aged 65+ years, rural community dwellers and those from culturally diverse populations, which will ensure their views are represented in the final DCE data.…”

Strategies to enable physical activity in individuals with traumatic brain injury

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We read with great interest the report titled "Physical activity and perceived barriers in individuals with moderate-to-severe traumatic brain injury" by Pham et al on physical activity in individuals with traumatic brain injury (TBI). 1 We appreciate the authors' efforts to identify barriers to physical activity for individuals with TBI and how these barriers vary with age. The study concluded that the main barriers to physical activity for individuals with TBI are lack of motivation and time and fatigue.

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