Which factors influence the activity levels of individuals with traumatic brain injury when they are first discharged home from hospital?

Hamilton, Megan; Williams, Gavin; Bryant, Adam; Clark, Ross; Spelman, Tim

doi:10.3109/02699052.2015.1075145

Cited by 26 publications

(9 citation statements)

References 70 publications

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“…Prior research in those with SCI found only 6.9% reported fear of leaving home as a barrier to exercise [34]; however, 39% of African-American women with severe physical disabilities reported that fear of leaving the home was a barrier [33]. There is a high rate of anxiety after brain injury [38], and anxiety has previously been identified as a barrier to physical activity and exercise participation [9,21]. It is plausible that the fear to leave the home is related to higher perceived environmental barriers.…”

Section: Personal Factorsmentioning

confidence: 99%

“…Current guidelines recommend that community-dwelling adults with a history of TBI perform 20 min of aerobic physical activity at low to moderate intensity at least 3 to 5 sessions per week along with strength, flexibility, and balance training [19]. Most individuals with TBI do not meet these recommendations [20,21], and their physical activity levels decline as early as one week following discharge from inpatient rehabilitation [21].…”

Section: Introductionmentioning

confidence: 99%

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Perceived Barriers to Exercise in Adults with Traumatic Brain Injury Vary by Age

Pinto¹,

Newman²,

Hirsch³

2018

JFMK

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Physical activity and exercise are important adjuncts to medical treatment for overall health in individuals with traumatic brain injury (TBI); however, many individuals do not partake in the recommended weekly exercise. The objective of this study was to investigate the barriers to exercise after TBI and determine whether these barriers varied by age. The sample was 172 adults with moderate to severe TBI who completed Barriers to Physical Exercise and Disability (B-PED) survey. Lack of interest, motivation, and energy as well as cost, lack of counseling on exercise by a physician, not having home equipment, and being too lazy were reported as barriers to exercise by all age groups. Those aged 35 to 54-years-old were more likely to report that cost, lack of transportation, having health concerns, not knowing where to exercise, and fear of leaving the home as barriers to exercise than those aged 18 to 34-years-old or 55-years-old and older. Overall, adults with TBI report multiple barriers to exercise, and these barriers vary by age.

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Section: Personal Factorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perceived Barriers to Exercise in Adults with Traumatic Brain Injury Vary by Age

Pinto¹,

Newman²,

Hirsch³

2018

JFMK

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“…Individuals who have acquired brain injuries can become prone to a sedentary lifestyle which places them at risk of secondary health complications (Shavelle et al, 2001). A number of studies have reported that individuals with a history of traumatic brain injury (TBI) are insufficiently active enough to receive a health benefit (Reavenall and Blake, 2010; Hamilton et al, 2015), according to current guidelines (Larry Durstine et al, 2012). The long-term health consequences of TBI include cognitive, sensorimotor, behavioral and social problems that can negatively affect quality of life (Stocchetti and Zanier, 2016), and in the US alone, an estimated 3.2 million individuals live with residual effects of TBI (Benedictus et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Traumatic Brain Injury Modifies the Relationship Between Physical Activity and Global and Cognitive Health: Results From the Barcelona Brain Health Initiative

Morris

Muñoz

Cattaneo

et al. 2019

Front. Behav. Neurosci.

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Physical activity has many health benefits for individuals with and without history of brain injury. Here, we evaluated in a large cohort study the impact of physical activity on global and cognitive health as measured by the PROMIS global health and NeuroQoL cognitive function questionnaires. A nested case control study assessed the influence of a history of traumatic brain injury (TBI) on the effects of physical activity since underlying pathophysiology and barriers to physical activity in individuals with TBI may mean the effects of physical activity on perceived health outcomes differ compared to the general population. Those with a history of TBI ( n = 81) had significantly lower Global health ( β = −1.66, p = 0.010) and NeuroQoL cognitive function ( β = −2.65, p = 0.006) compared to healthy adults ( n = 405). A similar proportion of individuals in both groups reported being active compared to being insufficiently active ( = 0.519 p = 0.471). Furthermore, the effect of physical activity on global health ( β = 0.061, p = 0.076) and particularly for NeuroQoL ( β = 0.159, p = 0.002) was greater in those with a history of TBI. Individuals with a history of TBI can adhere to a physically active lifestyle, and if so, that is associated with higher global and cognitive health perceptions. Adhering to a physically active lifestyle is non-trivial, particularly for individuals with TBI, and therefore adapted strategies to increase participation in physical activity is critical for the promotion of public health.

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“…The Upright Motor Control Test (UMCT) [ 20 ] or Upright Control (UC) Test [ 21 – 23 ] was originally developed as a clinician-administered clinical test of voluntary control of the affected lower limb in standing toward predicting functional walking ability in adults with stroke [C. Toman, unpublished thesis]. It is quick and simple to administer, requires no instrumentation and minimal physical space, and is therefore suitable for any clinical setting [ 24 ]. Clinically, it has been used to identify the presence of lower limb dyscontrol or muscle weakness in stroke [ 21 , 23 , 25 , 26 ] and other neurological conditions [ 22 , 24 , 27 ]; and/or to measure stroke rehabilitation outcomes in longitudinal studies [ 19 , 28 ], including clinical trials [ 29 – 31 ].…”

Section: Introductionmentioning

confidence: 99%

“…It is quick and simple to administer, requires no instrumentation and minimal physical space, and is therefore suitable for any clinical setting [ 24 ]. Clinically, it has been used to identify the presence of lower limb dyscontrol or muscle weakness in stroke [ 21 , 23 , 25 , 26 ] and other neurological conditions [ 22 , 24 , 27 ]; and/or to measure stroke rehabilitation outcomes in longitudinal studies [ 19 , 28 ], including clinical trials [ 29 – 31 ]. Since it is practical to administer and can be used on patients with muscle tone abnormalities and impairments in selective movement control from central nervous system lesions [ 20 ], it addresses the limitations related to dynamometry and MMT.…”

Section: Introductionmentioning

confidence: 99%

Measurement properties of the upright motor control test for adults with stroke: a systematic review

Gorgon

Lazaro

2016

Arch Physiother

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BackgroundThe Upright Motor Control Test (UMCT) has been used in clinical practice and research to assess functional strength of the hemiparetic lower limb in adults with stroke. It is unclear if evidence is sufficient to warrant its use. The purpose of this systematic review was to synthesize available evidence on the measurement properties of the UMCT for stroke rehabilitation.MethodsElectronic databases that indexed biomedical literature were systematically searched from inception until October 2015 (week 4): Embase, PubMed, Web of Science, CINAHL, PEDro, Cochrane Library, Scopus, ScienceDirect, SPORTDiscus, LILACS, DOAJ, and Google Scholar. All studies that had used the UMCT in the time period covered underwent hand searching for any additional study. Observational studies involving adults with stroke that explored any measurement property of the UMCT were included. The COnsensus-based Standards for the selection of health Measurement INstruments was used to assess the methodological quality of included studies. The CanChild Outcome Measures Rating Form was used for extracting data on measurement properties and clinical utility.ResultsThe search yielded three methodologic studies that addressed criterion-related validity and contruct validity. Two studies of fair methodological quality demonstrated moderate-level evidence that Knee Extension and Knee Flexion subtest scores were predictive of community-level and household-level ambulation. One study of fair methodological quality provided limited-level evidence for the correlation of Knee Extension subtest scores with a laboratory measure of ground reaction forces. No published studies formally assessed reliability, responsiveness, or clinical utility. Limited information on responsiveness and clinical utility dimensions could be inferred from the included studies.ConclusionsThe UMCT is a practical assessment tool for voluntary control or functional strength of the hemiparetic lower limb in standing in adults with stroke. Although different levels of evidence suggest that the Knee Extension and Knee Flexion subtests may possess criterion and construct validity, the lack of published literature examining content validity, reliability, and responsiveness raises questions regarding the use of the UMCT in routine clinical practice. These key findings highlight the need to further investigate the UMCT’s measurement properties toward enhancing its standardization.

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Which factors influence the activity levels of individuals with traumatic brain injury when they are first discharged home from hospital?

Abstract: PALs decreased significantly on discharge from hospital and remained below inpatient levels despite physical capacity for higher PALs. Motivation, fatigue and anxiety were important influencers of PALs during the transition home period.

Cited by 26 publications

References 70 publications

Perceived Barriers to Exercise in Adults with Traumatic Brain Injury Vary by Age

Perceived Barriers to Exercise in Adults with Traumatic Brain Injury Vary by Age

Traumatic Brain Injury Modifies the Relationship Between Physical Activity and Global and Cognitive Health: Results From the Barcelona Brain Health Initiative

Measurement properties of the upright motor control test for adults with stroke: a systematic review

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