Physical Activity and Sport for Acquired Brain Injury (PASABI): A Non-Randomized Controlled Trial

Effectiveness of an Exercise Therapy Program Based on Sports in Adults With Acquired Brain Injury: A Randomized Controlled Trial

OBJECTIVE

To examine the effects of a sport-based exercise therapy (ET) program combined with usual care (sET+UC) compared with usual care (UC) alone on health-related quality of life, upper limb motor control, functional capacity, mobility, balance, and physical activity participation in ambulant adults with acquired brain injury (ABI).

DESIGN

Single-blind, parallel-group, randomized controlled trial.

SETTING

Rehabilitation center.

PARTICIPANTS

Twenty-three adults with ABI (82.6% stroke; 17 men; mean age of 59.6±10.3y).

INTERVENTION

Participants received either sET+UC (n=11) or UC (n=12). The sET+UC group received sixteen 60-minute sessions of a sport-based ET program in addition to sixteen 60-minute sessions of UC, whereas the UC group attended UC only.

MAIN OUTCOME MEASURES

Primary outcome measures were health-related quality of life (Short Form-36 [SF-36]) and upper limb motor control (Fugl-Meyer Upper Extremity [FM-UE]), whereas the secondary included functional capacity (6-minute walk test and 10-meter walk test), mobility (timed Up and Go Test), balance (Berg Balance Scale), and physical activity participation (Global Physical Activity Questionnaire).

RESULTS

Significant differences were found in all outcome analyses at postintervention when comparing between groups. The sET+UC group showed significant improvements in both the physical (P=.027, r=.46) and mental component summary (P=.001, r=.71) of the SF-36 as well as FM-UE (P=.004, r=.60), with large effect sizes. In turn, all secondary outcomes were also significantly improved in this group (all P<.05 r>.05). In contrast, the UC group showed slight improvements in postintervention scores but did not reach significance in any of these measures.

CONCLUSIONS

This study shows that a sport-based ET program combined with UC can effectively improve all the aforementioned outcomes measures in ABI population. Further research with larger sample sizes and follow-up assessments is crucial to gain a more comprehensive understanding of the long-term effects of the intervention in this specific population.

More absolute moderate-to-vigorous physical activity is associated with better health-related quality of life in outpatients with an acquired brain injury

Health-related quality of life (HRQoL) is a patient-perceived measure of physical, social, and emotional health. Acquired brain injury (ABI) occurs due to damage to the brain after birth. Individuals with an ABI typically present with reduced HRQoL and require additional support to maintain their HRQoL. Although structured exercise training has been shown to improve HRQoL in individuals with ABI, there is little research on habitual, real-world activity. Most activity research characterizes moderate-to-vigorous physical activity (MVPA) in absolute terms; however, relative physical activity levels have been promoted for research in clinical populations. We tested whether longer MVPA durations, measured in absolute/relative levels, are associated with higher HRQoL in outpatients with ABIs. In total, 26 adults (54 ± 13 years, 16 females) with ABI completed the Quality of Life After Brain Injury questionnaire, a 6-min walk test (a measure of aerobic fitness; 490 ± 105 m), and wore an activPAL device 24 h/day for 7 days. Participants had an average HRQoL score of 53.4 ± 15.0 (out of 100), with 20 of 26 showing impaired HRQoL (score <60). Absolute MVPA (74.6 ± 91.0 min/week, b = 0.09, p = 0.03) was associated with HRQoL, whereas total physical activity (565.7 ± 264.8 min/week, p = 0.47), light physical activity (LPA; 491.1 ± 224.3 min/week, p = 0.98), and step count (5,960 ± 3,037 steps/day, p = 0.24) were not. Neither relative LPA (521.4 ± 244.9) nor relative MVPA (33.5 ± 34.9 min/week) were associated with HRQoL (both p values > 0.14). Targeting more absolute MVPA, but not necessarily relative MVPA, may be an effective strategy for interventions aiming to improve HRQoL in individuals with ABI.

Therapeutic groups run for community-dwelling people with acquired brain injury: a scoping review

PURPOSE

Therapeutic group interventions are commonly provided in acquired brain injury (ABI) inpatient rehabilitation settings, but little is known about the extent of therapeutic groups run for community-dwellers with ABI. This paper seeks to review current literature concerning the nature of therapeutic groups run for community-dwellers with ABI and the involvement of occupational therapists.

MATERIALS & METHODS

A scoping review was conducted with systematic searching of relevant databases guided by Arksey and O'Malley's framework. Studies were included if they reported on therapeutic groups for community-dwellers with ABI. Articles were collated and summarised with key findings presented in narrative form with accompanying tables.

RESULTS

Seventy articles met inclusion. Groups are used as therapeutic change agents for community-dwellers with ABI and target a diverse range of participation barriers. Participants valued group programs that established safe environments, a sense of belonging, growth opportunities and social connections. Group accessibility needs to be improved, with better funding avenues available for service providers, as well as greater consumer involvement in group design and facilitation.

CONCLUSIONS

Groups are a valuable therapeutic modality supporting community-dwellers with ABI. Further research is warranted into the use of groups by occupational therapists working with community-dwellers with ABI.

An Attempt to Develop a Model of Brain Waves Using Quantitative Electroencephalography with Closed Eyes in K1 Kickboxing Athletes-Initial Concept

BACKGROUND

Brain injuries are a common problem in combat sports, especially in disciplines such as kickboxing. Kickboxing is a combat sport that has several variations of competition, with the most contact-oriented fights being carried out under the format of K-1 rules. While these sports require a high level of skill and physical endurance, frequent micro-traumas to the brain can have serious consequences for the health and well-being of athletes. According to studies, combat sports are one of the riskiest sports in terms of brain injuries. Among the sports disciplines with the highest number of brain injuries, boxing, mixed martial arts (MMA), and kickboxing are mentioned.

METHODS

The study was conducted on a group of 18 K-1 kickboxing athletes who demonstrate a high level of sports performance. The subjects were between the ages 18 and 28. QEEG (quantitative electroencephalogram) is a numeric spectral analysis of the EEG record, where the data is digitally coded and statistically analysed using the Fourier transform algorithm. Each examination of one person lasts about 10 min with closed eyes. The wave amplitude and power for specific frequencies (Delta, Theta, Alpha, Sensorimotor Rhythm (SMR), Beta 1, and Beta2) were analysed using 9 leads.

RESULTS

High values were shown in the Alpha frequency for central leads, SMR in the Frontal 4 (F4 lead), Beta 1 in leads F4 and Parietal 3 (P3), and Beta2 in all leads.

CONCLUSIONS

The high activity of brainwaves such as SMR, Beta and Alpha can have a negative effect on the athletic performance of kickboxing athletes by affecting focus, stress, anxiety, and concentration. Therefore, it is important for athletes to monitor their brainwave activity and use appropriate training strategies to achieve optimal results.

Effectiveness of exercise in improving quality of life in patients with traumatic brain injury: A systematic review and meta-analysis

BACKGROUND

Traumatic brain injury (TBI) is a major cause of disability and mortality worldwide. People with TBI exhibit poor quality of life (QOL). Exercise is considered a possible intervention for improving cognitive function and mood, helping improve QOL in patients with TBI. According to our review of the relevant literature, meta-analyses have yet to explore the effect of exercise on QOL in patients with TBI.

OBJECTIVES

To determine by meta-analysis of relevant studies whether physical exercise could promote QOL in patients with TBI.

METHODS

A systematic review and meta-analysis of intervention studies involving physical exercise for improving QOL outcomes in TBI populations were conducted according to the PRISMA guideline. Our inclusion criteria were as follows: being randomized or nonrandomized controlled trials with quantitative designs that included patients diagnosed with TBI.

RESULTS

Thus, six studies met the inclusion criteria. The interventions in four of the six studies had statistically significant effects on QOL improvement. Our meta-analysis revealed a moderate effect size of physical exercise on QOL promotion in patients with TBI.

CONCLUSION

For TBI, exercise seems to improve QOL. More research with long-term follow-up should be conducted to assess the effect of exercise on patients with TBI.

Effects of Exercise Programs on Functional Capacity and Quality of Life in People With Acquired Brain Injury: A Systematic Review and Meta-Analysis

OBJECTIVE

The aims of this systematic review and meta-analyses were to evaluate the effects of exercise on the functional capacity and quality of life (QoL) of people with acquired brain injury (ABI) and to analyze the influence of training variables.

METHODS

Five electronic databases (MEDLINE, Cochrane Library, CINAHL, SportDiscus, and Web of Science) were searched until October 2021 for clinical trials or experimental studies examining the effects of exercise on the functional capacity and QoL in adults with ABI and comparing exercise interventions with non-exercise (usual care).

RESULTS

Thirty-eight studies were evaluated. A total sample of 2219 people with ABI (exercise, n = 1572; control, n = 647) were included in the quantitative analysis. A greater improvement was observed in walking endurance (z score = 2.84), gait speed (z score = 2.01), QoL physical subscale (z score = 3.42), and QoL mental subscale (z score = 3.00) was observed in the experimental group than in the control group. In addition, an improvement was also observed in the experimental group in the "Timed Up and Go" Test scores and balance without differences from the control group. Significant interactions were also observed between the rehabilitation phases, type, frequency and volume of training, and overall effects.

CONCLUSION

The results suggest that exercise improves functional capacity and QoL regardless of model training, highlighting the effectiveness of long-term exercise that includes short sessions with components such as strength, balance, and aerobic exercise.

IMPACT

The results shown in this systematic review with meta-analysis will allow physical therapists to better understand the effects of training on people with ABI.

Need of nutritional assessment and monitoring in a population with acquired brain injury: an analytical cross-sectional study

INTRODUCTION

Patients with acquired brain injury (ABI) may be at an increased risk of malnutrition due to the pathophysiology of their condition, which can affect their anthropometrical profile and therefore their quality of life. The present study analyzes the anthropometrical profile of these individuals, describes their dietary habits and nutrients intake and identifies the related risk factors influencing health status and quality of life.

METHODS

Twenty-three volunteers with ABI from the province of Granada (Spain) were recruited for this cross-sectional study. Nutritional assessment was quantitatively and qualitatively performed using a 72-h dietary record and a food frequency questionnaire, respectively. Body composition parameters were evaluated by bioelectrical impedance.

RESULTS

Low intakes of minerals related to bone health, extra virgin olive oil (EVOO) and fruits were reported. Moreover, women presented a poorer anthropometrical profile compared to men. With reference to age, a significant inverse correlation was observed with sarcopenic obesity, appendicular muscle mass index and Vitamin B₆ intake [(r = -0.617, p < 0.01), (r = -0.475, p < 0.05) and (r = -0.498, p < 0.05), respectively]. Intake of EVOO was inversely correlated to body mass index (r = -0.767, p < 0.001). Lastly, a direct correlation was observed between the consumption of alcohol and sweets and snacks (r = 0.608, p < 0.01).

CONCLUSION

The main findings support the existence of poor dietary quality and anthropometrical profile. Interdisciplinary team assessment would be beneficial to enhance the quality of life and attenuate the development of comorbidities in subjects with ABI.