Objective

To evaluate physical activity (PA) and sedentary behavior and their associations with symptom and quality of life outcomes in adults with persistent postconcussive symptoms (PPCS) after mild traumatic brain injury (mTBI).

Design

Cross-sectional cohort study.

Setting

Outpatient brain injury clinic.

Participants

Consecutive sample of adults (N=180) with a diagnosis of mTBI and PPCS.

Interventions

Not applicable.

Main Outcome Measures

PA and sedentary behavior were assessed using the Godin Leisure-Time Exercise Questionnaire and Rapid Assessment Disuse Index, respectively. Participants were dichotomized according to whether they completed 150 minutes of moderate-to-vigorous PA per week, based on Canadian guidelines. Postinjury moderate-to-vigorous PA was also analyzed as a continuous variable.

Results

Prior to injury, 85% of participants reported meeting PA guidelines, compared with 28% postinjury. Individuals meeting PA guidelines postinjury reported higher quality of life (η²_p=0.130; P<.001) and lower scores on measures of functional impact of headache (η²_p=0.065; P=.009), fatigue (η²_p=0.080; P=.004), depression (η²_p=0.085; P=.001), and anxiety (η²_p=0.046; P=.031), compared with those not meeting guidelines. Sedentary behavior postinjury was negatively correlated with quality of life (r_s[127]=–0.252; P=.004) and positively correlated with symptom burden (r_s[167]=0.227; P=.003), fatigue (r_s[127]=0.288; P=.001), depression (r_s[174]=0.319; P<.001), and anxiety (r_s[127]=0.180; P=.042).

Conclusions

PA was significantly decreased in individuals with PPCS compared to preinjury levels. Meeting PA guidelines postinjury was associated with better clinical outcomes, suggesting that returning individuals to PA should be considered in the treatment of this patient population.

中文翻译：

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表征轻度创伤性脑损伤后持续脑震荡后症状的成年人的身体活动和久坐行为

客观的

评估轻度创伤性脑损伤 (mTBI) 后有持续脑震荡后症状 (PPCS) 的成人的身体活动 (PA) 和久坐行为及其与症状和生活质量结果的关联。

设计

横断面队列研究。

环境

脑损伤门诊。

参与者

诊断为 mTBI 和 PPCS 的成人（N=180）的连续样本。

干预措施

不适用。

主要观察指标

PA 和久坐行为分别使用 Godin 闲暇时间运动问卷和快速评估废用指数进行评估。根据加拿大的指导方针，参与者根据他们是否每周完成 150 分钟的中等强度到剧烈运动进行二分。伤后中度至剧烈的 PA 也作为连续变量进行分析。

结果

受伤前，85% 的参与者报告符合 PA 指南，而受伤后为 28%。伤后符合 PA 指南的个体报告了更高的生活质量 (η ² _p =0.130; P <.001) 和头痛对功能影响的测量得分较低 (η ² _p =0.065; P =.009)、疲劳 (η ² _p =0.080; P =.004)、抑郁 (η ² _p =0.085; P =.001) 和焦虑 (η ² _p =0.046; P =.031)，与不符合指南的患者相比。伤后久坐行为与生活质量呈负相关（r _s[127]=–0.252；P =.004) 并与症状负担 (r _s [167]=0.227; P =.003)、疲劳 (r _s [127]=0.288; P =.001)、抑郁 (r _s [174]= 0.319；P <.001）和焦虑（r _s [127]=0.180；P =.042）。

结论

与伤前水平相比，PPCS 患者的 PA 显着降低。伤后符合 PA 指南与更好的临床结果相关，这表明在治疗该患者群体时应考虑让患者返回 PA。