Physical activity, fatigue and sleep quality at least 6 months after mild traumatic brain injury in adolescents and young adults: A comparison with orthopedic injury controls

Functional neurological disorder, physical activity and exercise: What we know and what we can learn from comorbid disorders

“…Exercise is thought to improve post-concussive symptoms through improved cerebral blood flow and enhanced neuroplasticity contributing to restoration of integrity of brain networks, as shown in functional magnetic resonance imaging (fMRI) studies of patients with PPCS who exercised daily on a treadmill compared to non-exercising PPCS controls [66] . However, patients with PPCS tend to be less active [67] . As such, many small trials have focused on exercise in this activity-deficient group.…”

“…GET: Graded Exercise Therapy; CBT: Cognitive Behavioral Therapy. FND Comorbid Disorder Activity Patterns Evidence for therapeutic use of Physical activity and Exercise References Fibromyalgia Less physical activity compared to controls Aerobic Exercise (sustained increased heart rate, ex: treadmill, walking, Zumba, water aerobics) : decreased pain, reduced symptom severity, decreased pain catastrophizing [31] , [32] , [33] , [37] , [40] , [41] , [44] , [46] , [48] Lack of regular exercise Strength/Resistance training (contracting muscles against resistance, ex: weight lifting, body weight) : decreased pain perception, improved quality of life Kinesiophobia Combined Programs (aerobic + stretching + resistance training) : reduced pain intensity, improved quality of life, physical functioning, and psychological functioning, decreased depression, improved cognition Chronic fatigue syndrome 40 % reduction in activity compared to controls GET + CBT : reduced fatigue and improved physical function at 1 year [52] , [53] Pacing : use remains controversial Persistent post-concussion symptoms Decreased activity compared to MSK injury controls Aerobic Exercise : improved severity and number of symptoms, decreased kinesiophobia, decreased anxiety, decreased fatigue, improved quality of life [66] , [67] , [69] Postural orthostatic tachycardia syndrome Inability to tolerate >30 min of exercise Aerobic Exercise : resolution of diagnosis, improved overall well-being and quality of life [70] , [71] Kinesiophobia and postural intolerance Horizontal exercises (ex: rowing, swimming, recumbent bike) : improved tolerance of exercise regimens Chronic Pain Decreased activity Aerobic Exercise (treadmill, walking, dance) : improved functional status, well-being, pain ac...…”

Does a concussion in adolescents increase likelihood of developing insomnia?

“…A 2018 cross-sectional, case-controlled study examined whether adolescents with mTBI had differences in sleep quality compared with same-aged controls who had non–head-related orthopedic injuries. 2 Patients were 12 to 25 years old with a mean age around 15 years old and diagnosed with either mTBI (CGS 13 or greater) or a fracture of an extremity. Those with a head injury and an orthopedic fracture or a medical or psychological condition were excluded.…”