Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-20T10:39:52.977Z Has data issue: false hasContentIssue false
  • English
  • Français

Objective Assessment of Activity in Inpatients with Traumatic Brain Injury: Initial Findings

Published online by Cambridge University Press:  28 October 2015

Simon Driver Open the ORCID record for Simon Driver [Opens in a new window] ,
Lauren Rachal ,
Chad Swank  and
Randi Dubiel
Simon Driver*
Affiliation:
Baylor Institute for Rehabilitation, Physical Medicine and Rehabilitation, Dallas, Texas, USA
Lauren Rachal
Affiliation:
Baylor Institute for Rehabilitation, Physical Medicine and Rehabilitation, Dallas, Texas, USA
Chad Swank
Affiliation:
Baylor Institute for Rehabilitation, Physical Medicine and Rehabilitation, Dallas, Texas, USA Texas Woman's University, School of Physical Therapy, Dallas, Texas, USA
Randi Dubiel
Affiliation:
Baylor Institute for Rehabilitation, Physical Medicine and Rehabilitation, Dallas, Texas, USA
*
*Address for correspondence: Simon Driver, 909 N. Washington Avenue, Suite 232, Dallas, Texas, 75246. E-mail: [email protected], 214-820-9014.
Get access

Abstract

Purpose: Use accelerometers to examine the physical activity behaviours of individuals following TBI undergoing inpatient rehabilitation.

Method: Twenty-one individuals with Traumatic brain injury (TBI) undergoing inpatient rehabilitation (9 females, 12 males; M age = 43.8 ± 14.7 years; M GCS = 9.1 ± 4.3; M time since injury = 40.8 ± 22.1 days; M length of stay (LOS) = 30 ± 14 days) wore accelerometers for an average of 8.4 ± 2.0 consecutive days (1440 minutes/day). Activity counts (AC) were collected at 1 minute epochs and descriptive statistics were calculated to assess intensity of activity and time spent being active and sedentary.

Results: During scheduled therapy, time individuals completed an average of 161.4 ± 65.5 AC/minute, which decreased to 114.5 ± 51.3 during non-therapy time and 22.2 ± 10 when sleeping. Using population level cut points, individuals were on average considered inactive during therapy, inactive or sedentary during non-therapy time, and only one participant spent >1 minute in moderate intensity activity. The mean length of active and sedentary bouts was 9 minutes.

Discussion: Findings indicate that the amount and intensity of activity completed is low amongst individuals completing inpatient rehabilitation after TBI, with the majority considered sedentary or inactive. While the sample is small, it is important to develop and implement safe and effective strategies to increase activity levels during rehabilitation.

Keywords

Head injuryexerciseaccelerometersrehabilitation
Type
Articles
Information
Brain Impairment , Volume 17 , Issue 1: Physical Activity in Neurological Populations , March 2016 , pp. 55 - 63
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amonette, W.E., & Mossberg, K.A. (2013). Ventilatory anaerobic thresholds of individuals recovering from traumatic brain injury compared with noninjured controls. The Journal of Head Trauma Rehabilitation, 28 (5), E13–E20. doi:10.1097/HTR.0b013e31826463a1.Google Scholar
Archer, T. (2012). Influence of physical exercise on traumatic brain injury deficits: scaffolding effect. Neurotoxicity Research, 21 (4), 418–434. doi:10.1007/s12640-011-9297-0.CrossRefGoogle ScholarPubMed
Archer, T., Svensson, K., & Alricsson, M. (2012). Physical exercise ameliorates deficits induced by traumatic brain injury. Acta Neurologica Scandinavica, 125 (5), 293–302. doi:10.1111/j.1600-0404.2011.01638.x.Google Scholar
Banham-Hall, N., Kothwal, K., Pipkin, J., Bentley, J., & Dickens, G.L. (2013). Prevalence of low bone mineral density in inpatients with traumatic brain injury receiving neurobehavioural rehabilitation: a postoperative, observational study. Physiotherapy, 99 (4), 328–334. doi:10.1016/j.physio.2012.12.009.CrossRefGoogle ScholarPubMed
Berlin, A.A., Kop, W.J., & Deuster, P.A. (2006). Depressive mood symptoms and fatigue after exercise withdrawal: the potential role of decreased fitness. Psychosomatic Medicine, 68 (2), 224–230. doi:68/2/224.Google Scholar
Bhambhani, Y., Rowland, G., & Farag, M. (2005). Effects of circuit training on body composition and peak cardiorespiratory responses in patients with moderate to severe traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 86 (2), 268–276. doi:S0003999304004721.CrossRefGoogle ScholarPubMed
Brown, A.W., Leibson, C.L., Malec, J.F., Perkins, P.K., Diehl, N.N., & Larson, D.R. (2004). Long-term survival after traumatic brain injury: a population-based analysis. Neurorehabilitation, 19 (1), 37–43.Google Scholar
Canning, C.G., Shepherd, R.B., Carr, J.H., Alison, J.A., Wade, L., & White, A. (2003). A randomized controlled trial of the effects of intensive sit-to-stand training after recent traumatic brain injury on sit-to-stand performance. Clinical Rehabilitation, 17 (4), 355–362.Google Scholar
Cuddy, J.S., Gaskill, S.E., Sharkey, B.J., Harger, S.G., & Ruby, B.C. (2007). Supplemental feedings increase self-selected work output during wildfire suppression. Medicine and Science in Sports and Exercise, 39 (6), 1004–1012. doi:10.1249/mss.0b013e318040b2fb.Google Scholar
Cuthbert, J.P., Corrigan, J.D., Whiteneck, G.G., Harrison-Felix, C., Graham, J.E., Bell, J.M., & Coronado, V.G. (2012). Extension of the representativeness of the traumatic brain injury model systems national database: 2001 to 2010. The Journal of Head Trauma Rehabilitation, 27 (6), E15–E27. doi:10.1097/HTR.0b013e31826da983.Google Scholar
DeJong, G., Hsieh, C.H., Putman, K., Smout, R.J., Horn, S.D., & Tian, W. (2011). Physical therapy activities in stroke, knee arthroplasty, and traumatic brain injury rehabilitation: their variation, similarities, and association with functional outcomes. Physical Therapy, 91 (12), 1826–1837. doi:10.2522/ptj.20100424.Google Scholar
Driver, S. (2008). Development of a conceptual model to predict physical activity participation in adults with brain injuries. Adapted Physical Activity Quarterly, 25 (4), 289–307.Google Scholar
Driver, S. (2009). What barriers to physical activity do outpatients with a traumatic brain injury face? Journal of Cognitive Rehabilitation, 33(Fall Issue), 4–10.Google Scholar
Driver, S., Ede, A., Dodd, Z., Stevens, L., & Warren, A.M. (2012). What barriers to physical activity do individuals with a recent brain injury face? Disability and Health Journal, 5 (2), 117–125. doi:10.1016/j.dhjo.2011.11.002.CrossRefGoogle ScholarPubMed
Driver, S., Irwin, K., Woolsey, A., & Pawlowski, J. (2012). Creating an effective physical activity-based health promotion programme for adults with a brain injury. Brain Injury, 26 (12), 1482–1492.Google Scholar
Freedson, P.S., Melanson, E., & Sirard, J. (1998). Calibration of the computer science and applications, inc. accelerometer. Medicine and Science in Sports and Exercise, 30 (5), 777–781.Google Scholar
Galvin, R., Cusack, T., O’Grady, E., Murphy, T.B., & Stokes, E. (2011). Family-mediated exercise intervention (FAME): evaluation of a novel form of exercise delivery after stroke. Stroke; a Journal of Cerebral Circulation, 42 (3), 681–686. doi:10.1161/STROKEAHA.110.594689.CrossRefGoogle ScholarPubMed
Galvin, R., Stokes, E., & Cusack, T. (2014). Family-mediated exercises (FAME): an exploration of participant's involvement in a novel form of exercise delivery after stroke. Topics in Stroke Rehabilitation, 21 (1), 63–74. doi:10.1310/tsr2101-63.Google Scholar
Gray, D.S., & Burnham, R.S. (2000). Preliminary outcome analysis of a long-term rehabilitation program for severe acquired brain injury. Archives of Physical Medicine and Rehabilitation, 81 (11), 1447–1456. doi:S0003-9993(00)67396-3.Google Scholar
Hassett, L., Moseley, A., Harmer, A., & van der Ploeg, H.P. (2015). The reliability, validity, and feasibility of physical activity measurement in adults with traumatic brain injury: an observational study. The Journal of Head Trauma Rehabilitation, 30 (2), E55–E61. doi:10.1097/HTR.0000000000000047.Google Scholar
Hassett, L.M., Moseley, A.M., Whiteside, B., Barry, S., & Jones, T. (2012). Circuit class therapy can provide a fitness training stimulus for adults with severe traumatic brain injury: a randomised trial within an observational study. Journal of Physiotherapy, 58 (2), 105–112. doi:10.1016/S1836-9553(12)70090-5.CrossRefGoogle ScholarPubMed
Jackson, W.T., Novack, T.A., & Dowler, R.N. (1998). Effective serial measurement of cognitive orientation in rehabilitation: the orientation log. Archives of Physical Medicine and Rehabilitation, 79 (6), 718–720. doi:S0003-9993(98)90051-X.Google Scholar
Jackson, D., Turner-Stokes, L., Culpan, J., Bateman, A., Scott, O., Powell, J., & Greenwood, R. (2001). Can brain-injured patients participate in an aerobic exercise programme during early inpatient rehabilitation? Clinical Rehabilitation, 15 (5), 535–544.Google Scholar
Kushida, C.A., Chang, A., Gadkary, C., Guilleminault, C., Carrillo, O., & Dement, W.C. (2001). Comparison of actigraphic, polysomnographic, and subjective assessment of sleep parameters in sleep-disordered patients. Sleep Medicine, 2 (5), 389–396. doi:S1389-9457(00)00098-8.Google Scholar
Kuys, S., Brauer, S., & Ada, L. (2006). Routine physiotherapy does not induce a cardiorespiratory training effect post-stroke, regardless of walking ability. Physiotherapy Research International: The Journal for Researchers and Clinicians in Physical Therapy, 11 (4), 219–227.Google Scholar
MacKay-Lyons, M.J., & Makrides, L. (2002). Cardiovascular stress during a contemporary stroke rehabilitation program: Is the intensity adequate to induce a training effect? Archives of Physical Medicine and Rehabilitation, 83 (10), 1378–1383. doi:S0003999302000552.Google Scholar
Mang, C.S., Snow, N.J., Campbell, K.L., Ross, C.J., & Boyd, L.A. (2014). A single bout of high-intensity aerobic exercise facilitates response to paired associative stimulation and promotes sequence-specific implicit motor learning. Journal of Applied Physiology, 117 (11), 1325–1336. doi:10.1152/japplphysiol.00498.2014.Google Scholar
Matthews, C.E., Chen, K.Y., Freedson, P.S., Buchowski, M.S., Beech, B.M., Pate, R.R., & Troiano, R.P. (2008). Amount of time spent in sedentary behaviors in the united states, 2003–2004. American Journal of Epidemiology, 167 (7), 875–881. doi:10.1093/aje/kwm390.CrossRefGoogle ScholarPubMed
Mattlage, A.E., Redlin, S.A., Rippee, M.A., Abraham, M.G., Rymer, M.M., & Billinger, S.A. (2015). Use of accelerometers to examine sedentary time on an acute stroke unit. Journal of Neurologic Physical Therapy. 39 (3), 166–171.Google Scholar
McDermott, S., Moran, R., Platt, T., Isaac, T., Wood, H., & Dasari, S. (2007). Risk for onset of health conditions among community-living adults with spinal cord and traumatic brain injuries. Primary Health Care Research & Development (Cambridge University Press/UK), 8 (1), 36–43. doi:10.1017/S1463423607000059.Google Scholar
Mossberg, K.A., Amonette, W.E., & Masel, B.E. (2010). Endurance training and cardiorespiratory conditioning after traumatic brain injury. The Journal of Head Trauma Rehabilitation, 25 (3), 173–183. doi:10.1097/HTR.0b013e3181dc98ff.Google Scholar
Mossberg, K.A., Ayala, D., Baker, T., Heard, J., & Masel, B. (2007). Aerobic capacity after traumatic brain injury: comparison with a nondisabled cohort. Archives of Physical Medicine & Rehabilitation, 88 (3), 315–320.CrossRefGoogle ScholarPubMed
Mulder, E., Clement, G., Linnarsson, D., Paloski, W.H., Wuyts, F.P., Zange, J., Rittweger, J. (2015). Musculoskeletal effects of 5 days of bed rest with and without locomotion replacement training. European Journal of Applied Physiology, 115 (4), 727–738. doi:10.1007/s00421-014-3045-0.Google Scholar
National Health and Nutrition Examination Survey. (2014). Examination and Laboratory Procedure Manuals. Retrieved from http://wwwn.cdc.gov/nchs/nhanes/search/nhanes13_14.aspx.Google Scholar
Pawlowski, J., Dixon-Ibarra, A., & Driver, S. (2013). Review of the status of physical activity research for individuals with traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 94 (6), 1184–1189. doi:10.1016/j.apmr.2013.01.005.Google Scholar
Selassie, A.W., Cao, Y., Church, E.C., Saunders, L.L., & Krause, J. (2014). Accelerated death rate in population-based cohort of persons with traumatic brain injury. The Journal of Head Trauma Rehabilitation, 29 (3), E8–E19. doi:10.1097/HTR.0b013e3182976ad3.Google Scholar
Self, M., Driver, S., Stevens, L., & Warren, A.M. (2013). Physical activity experiences of individuals living with a traumatic brain injury: a qualitative research exploration. Adapted Physical Activity Quarterly, 30 (1), 20–39.Google Scholar
Shiel, A., Burn, J.P., Henry, D., Clark, J., Wilson, B.A., Burnett, M.E., & McLellan, D.L. (2001). The effects of increased rehabilitation therapy after brain injury: results of a prospective controlled trial. Clinical Rehabilitation, 15 (5), 501–514.Google Scholar
Slade, A., Tennant, A., & Chamberlain, M.A. (2002). A randomised controlled trial to determine the effect of intensity of therapy upon length of stay in a neurological rehabilitation setting. Journal of Rehabilitation Medicine, 34 (6), 260–266.Google Scholar
Traumatic Brain Injury Model Systems. (2015). Identification of Subjects. Retrieved from https://www.tbindsc.org/SOP.aspx.Google Scholar
Troiano, R.P., Berrigan, D., Dodd, K.W., Masse, L.C., Tilert, T., & McDowell, M. (2008). Physical activity in the united states measured by accelerometer. Medicine and Science in Sports and Exercise, 40 (1), 181–188. doi:10.1249/mss.0b013e31815a51b3.Google Scholar
Tudor-Locke, C., Ainsworth, B.E., Thompson, R.W., & Matthews, C.E. (2002). Comparison of pedometer and accelerometer measures of free-living physical activity. Medicine and Science in Sports and Exercise, 34 (12), 2045–2051. doi:10.1249/01.MSS.0000039300.76400.16.CrossRefGoogle ScholarPubMed
Tudor-Locke, C., Johnson, W.D., & Katzmarzyk, P.T. (2009). Accelerometer-determined steps per day in US adults. Medicine and Science in Sports and Exercise, 41 (7), 1384–1391. doi:10.1249/MSS.0b013e318199885c.Google Scholar
Tweedy, S.M., & Trost, S.G. (2005). Validity of accelerometry for measurement of activity in people with brain injury. Medicine and Science in Sports and Exercise, 37 (9), 1474–1480. doi:00005768-200509000-00004.Google Scholar
Wilson, D.J., Powell, M., Gorham, J.L., & Childers, M.K. (2006). Ambulation training with and without partial weightbearing after traumatic brain injury: results of a randomized, controlled trial. American Journal of Physical Medicine & Rehabilitation, 85 (1), 68–74. doi:00002060-200601000-00010.CrossRefGoogle ScholarPubMed