TBI is defined by the Brain Injury Association of America as “an alteration in brain function, or other evidence of brain pathology, caused by an external force. Traumatic impact injuries can be defined as closed (or non-penetrating) or open (penetrating)” (n.d.) In other words, TBI is caused by a severe hit to the head from something external that causes the brain to function differently. There are a number of symptoms that can come as a result of TBI. According to an article off of TraumaticBrainInjury.com (n.d.), these symptoms include:
Speed of Processing
Control of bowel and bladder
Loss of stamina
Regulation of body temperature
Lack of motivation
Denial/lack of awareness
All of these symptoms that may come with TBI can make the lives of individuals with TBI, as well as the lives of their caretakers, very difficult. There are numerous pharmaceutical medications coming out that are supposed to help reduce or prevent certain symptoms of TBI (antidepressants, anti-seizure meds, anti-psychotic meds etc.) but what if I were to tell you that moderate intensity exercise may also help? Persons with TBI have been known to be physically inactive, which may lead to reduced levels of fitness as well as potentially raise their risk of secondary health conditions. These secondary health conditions that are often correlated to physical inactivity might potentially be exacerbating any symptoms that an individual with TBI is already dealing with.
What exactly is the best type of exercise for individuals with TBI though? Well, the answer is that there is no specific type of exercise that individuals with TBI need to focus on because, just like a typical person without TBI, it is best to get a variety of different types of training in for basic overall health benefits. Plus, it is only fair to let the individual with TBI be in charge of choosing what type of exercise routines they follow because they’re more likely to continue with the routine if they enjoy it. If it feels like a chore to them, it may increase their desire to quit sooner (again, no different from typical persons without TBI).
When a person with TBI is getting ready to start an exercise routine, they must first be cleared by a physician to ensure that there are no other underlying health conditions that would restrict their ability to increase their levels of physical activity. Once official clearance from their physician has been received, it is smart for persons with TBI to get an official assessment of their current fitness levels. These assessments can be done on a treadmill, cycle ergometer, or any other machine that has the ability to increase the workload in an incremental way. If there is no access to a reliable machine for this assessment, alternatives can be implemented such as the six minute walk test. The six minute walk test involves the person with TBI getting assessed on how far they walk in six minutes, followed by having their heart rate measured directly after the test is completed.
The biggest responsibility for a trainer working with persons with TBI is to guide them through an exercise routine safely and effectively. A trainer's biggest hope should be that their client is eventually able to exercise more independently with less direct guidance (basically working themselves out of a job so to speak). There is a chance that if a person with TBI is able to increase their independence in their exercise routine, it may potentially translate to increased levels of independence in other parts of their daily life as well.
When looking at the outcomes of exercise programs for persons with TBI, numerous studies have shown that exercise may have major long-term benefits for both their physical and mental health. These benefits include:
Increased prevention of chronic diseases associated with a sedentary lifestyle
Increased ability to maintain and progress in their physical work capacity
Increased levels of cardiovascular endurance
Increases ability to balance on unstable surfaces
Increased ability to manage and reduce levels of fatigue and stress
Increased ability to perform activities of daily living
Decreased reliance on assistance from others or assistive devices
Increased levels of self-esteem
Increased ability to interact and socialize with peers
Decreased risks of developing depression
Decreased incidences of aggressive behaviors
In conclusion, the potential health benefits of getting consistent exercise are substantial and may help persons with TBI increase not just their physical health, but also their mental health as well. With increased physical and mental health, persons with TBI may have greater chances at increasing their levels of independence, decreasing their reliance on assistance from others, improving their abilities to perform activities of daily living, and (most importantly) increase their overall quality of life.
Exercise for People with a Traumatic Brain Injury : NCHPAD - Building Inclusive Communities. (n.d.). Retrieved October 27, 2018, from https://www.nchpad.org/1407/6273/Exercise~for~People~with~a~Traumatic~Brain~Injury
DeNiel, C., PT, DPT. (n.d.). Move it or Lose it: The Benefits of Movement and Exercise in Traumatic Brain Injuries. Retrieved October 31, 2018, from https://www.braininjurymn.org/annual_conference/CONF-2017-presentations/Friday-I-E.pdf
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), 173-83.“Severe TBI Symptoms.” TraumaticBrainInjury.com www.traumaticbraininjury.com/symptoms-of-tbi/severe-tbi-symptoms/.