1
|
Zafarullah M, Angkustsiri K, Quach A, Yeo S, Durbin-Johnson BP, Bowling H, Tassone F. Untargeted metabolomic, and proteomic analysis identifies metabolic biomarkers and pathway alterations in individuals with 22q11.2 deletion syndrome. Metabolomics 2024; 20:31. [PMID: 38418685 PMCID: PMC10901937 DOI: 10.1007/s11306-024-02088-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 01/05/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION The chromosome 22q11.2 deletion syndrome (22q11.2DS) is characterized by a well-defined microdeletion and is associated with a wide range of brain-related phenotypes including schizophrenia spectrum disorders (SCZ), autism spectrum disorders (ASD), anxiety disorders and attention deficit disorders (ADHD). The typically deleted region in 22q11.2DS contains multiple genes which haploinsufficiency has the potential of altering the protein and the metabolic profiles. OBJECTIVES Alteration in metabolic processes and downstream protein pathways during the early brain development may help to explain the increased prevalence of the observed neurodevelopmental phenotypes in 22q11.2DS. However, relatively little is known about the correlation of dysregulated protein/metabolite expression and neurobehavioral impairments in individuals who developed them over time. METHODS In this study, we performed untargeted metabolic and proteomic analysis in plasma samples derived from 30 subjects including 16 participants with 22q11.2DS and 14 healthy controls (TD) enrolled in a longitudinal study, aiming to identify a metabolic and protein signature informing about the underlying mechanisms involved in disease development and progression. The metabolic and proteomic profiles were also compared between the participants with 22q11.2DS with and without various comorbidities, such as medical involvement, psychiatric conditions, and autism spectrum disorder (ASD) to detect potential changes among multiple specimens, collected overtime, with the aim to understand the basic underlying mechanisms involved in disease development and progression. RESULTS We observed a large number of statistically significant differences in metabolites between the two groups. Among them, the levels of taurine and arachidonic acid were significantly lower in 22q11.2DS compared to the TD group. In addition, we identified 16 proteins that showed significant changes in expression levels (adjusted P < 0.05) in 22q11.2DS as compared to TD, including those involved in 70 pathways such as gene expression, the PI3K-Akt signaling pathway and the complement system. Within participants with 22q11.2DS, no significant changes in those with and without medical or psychiatric conditions were observed. CONCLUSION To our knowledge, this is the first report on plasma metabolic and proteomic profiling and on the identification of unique biomarkers in 22q11.2DS. These findings may suggest the potential role of the identified metabolites and proteins as biomarkers for the onset of comorbid conditions in 22q11.2DS. Ultimately, the altered protein pathways in 22q11.2DS may provide insights of the biological mechanisms underlying the neurodevelopmental phenotype and may provide missing molecular outcome measures in future clinical trials to assess early-diagnosis treatment and the efficacy of response to targeted treatment.
Collapse
Affiliation(s)
- Marwa Zafarullah
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California Davis, Sacramento, CA, 95817, USA
| | - Kathleen Angkustsiri
- Department of Pediatrics, School of Medicine, University of California Davis, Sacramento, CA, 95817, USA
- MIND Institute, University of California Davis Medical Center, Sacramento, CA, 95817, USA
| | | | | | | | | | - Flora Tassone
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California Davis, Sacramento, CA, 95817, USA.
- MIND Institute, University of California Davis Medical Center, Sacramento, CA, 95817, USA.
| |
Collapse
|
2
|
Johnson L, Williams G, Sherrington C, Pilli K, Chagpar S, Auchettl A, Beard J, Gill R, Vassallo G, Rushworth N, Tweedy S, Simpson G, Scheinberg A, Clanchy K, Tiedemann A, Hassett L. The effect of physical activity on health outcomes in people with moderate-to-severe traumatic brain injury: a rapid systematic review with meta-analysis. BMC Public Health 2023; 23:63. [PMID: 36624502 PMCID: PMC9830875 DOI: 10.1186/s12889-022-14935-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND In 2020, the World Health Organization (WHO) released the first global physical activity and sedentary behaviour guidelines for children and adults living with disability. The evidence informing the guidelines though is not specific to people living with traumatic brain injury (TBI), but rather comes from other disabling conditions such as Parkinson's disease, and stroke. There remains a clear lack of direct evidence of the effects of physical activity for people living with TBI. The objective of this rapid review was to identify direct evidence of the effect of physical activity on health outcomes in people with moderate-to-severe TBI to inform adaptation of the WHO physical activity guidelines into clinical practice guidelines. METHODS We conducted a rapid systematic review with meta-analysis of randomised controlled trials, including people of any age with moderate-to-severe TBI, investigating physical activity interventions compared to either usual care, a physical activity intervention with different parameters, or a non-physical activity intervention. Four databases (CENTRAL, SPORTDiscus, PEDro, Ovid MEDLINE) were searched from inception to October 8, 2021. The primary outcomes were physical function, cognition, and quality of life. RESULTS Twenty-three studies were included incorporating 812 participants (36% females, majority working-age adults, time post-TBI in studies ranged from 56 days (median) to 16.6 years (mean)). A range of physical activity interventions were evaluated in rehabilitation (n = 12 studies), community (n = 8) and home (n = 3) settings. We pooled data from the end of the intervention for eight outcomes. Participation in a virtual reality physical activity intervention improved mobility, assessed by the Community Balance and Mobility Scale (range 0 to 96; higher score indicates better mobility) more than standard balance training (two studies, 80 participants, Mean Difference = 2.78, 95% CI 1.40 to 4.16; low certainty evidence). There was uncertainty of effect for the remaining outcomes, limited by small sample sizes, diverse comparators and a wide range of outcome measures. CONCLUSION This review consolidates the current evidence base for the prescription of physical activity for people with moderate-to-severe TBI. There remains a pressing need for further rigorous research in order to develop practice guidelines to support clinical decision-making when prescribing physical activity in this population.
Collapse
Affiliation(s)
- Liam Johnson
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.,School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Gavin Williams
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.,Physiotherapy Department, Epworth HealthCare, Melbourne, Australia
| | - Catherine Sherrington
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Kavya Pilli
- Liverpool Brain Injury Rehabilitation Unit, South Western Sydney Local Health District, Sydney, Australia
| | - Sakina Chagpar
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Aylish Auchettl
- Physiotherapy Department, Epworth HealthCare, Melbourne, Australia
| | - Jack Beard
- Physiotherapy Department, Epworth HealthCare, Melbourne, Australia
| | - Renee Gill
- Physiotherapy Department, Epworth HealthCare, Melbourne, Australia
| | | | | | - Sean Tweedy
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Grahame Simpson
- Liverpool Brain Injury Rehabilitation Unit, South Western Sydney Local Health District, Sydney, Australia.,John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District, The University of Sydney and Northern Sydney Local Health District, Sydney, Australia
| | - Adam Scheinberg
- Murdoch Children's Research Institute, Melbourne, Australia.,School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Kelly Clanchy
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Australia.,Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| | - Anne Tiedemann
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Leanne Hassett
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia. .,Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. .,The University of Sydney, Susan Wakil Health Building, D19 Western Ave, Camperdown, NSW, 2006, Australia.
| |
Collapse
|
3
|
Quilico EL, Alarie C, Swaine BR, Colantonio A. Characteristics, Outcomes, Sex and Gender Considerations of Community-Based Physical Activity Interventions after Moderate-to-Severe Traumatic Brain Injury: Scoping Review. Brain Inj 2022; 36:295-305. [PMID: 35394859 DOI: 10.1080/02699052.2022.2059815] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This scoping review mapped the current evidence about community-based physical activity (PA) interventions for individuals with moderate-to-severe traumatic brain injury (TBI) and identified the reported health-related outcomes, measurement tools used, and considerations given to sex and gender. METHODS Searches were conducted in six academic databases for peer-reviewed articles (MEDLINE, EMBASE, Cochrane CENTRAL, CINAHL, SPORTDiscus, and PEDro). PRISMA Scoping Review guidelines were followed. Two reviewers independently screened articles for inclusion and extracted data for the analysis with a modified Consensus on Exercise Reporting Template (CERT). Health-related outcomes were classified with domains of the International Classification of Function, Disability and Health (ICF). RESULTS 19 studies were identified. Seven PA intervention types were included. CERT scores varied (M = 12.74, SD = 3.51 items), with limited details for replication. ICF outcomes focused on improving body functions (74%), activities and participation (14%), environmental factors (1%), and other: not covered (11%). Only four studies (21%) stratified their results by sex or gender. CONCLUSIONS Identified PA interventions from this review revealed common characteristics that led to improved outcomes. Proposed recommendations aim to improve future research and community practice. There is a pressing need for more sex and gender considerations in PA research after moderate-to-severe TBI.
Collapse
Affiliation(s)
- Enrico L Quilico
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | | | - Bonnie R Swaine
- École de réadaptation, Université de Montréal, Montréal, QC, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
4
|
Jackson M, Kang M, Furness J, Kemp-Smith K. Aquatic Exercise and Mental Health: A Scoping Review. Complement Ther Med 2022; 66:102820. [PMID: 35218906 DOI: 10.1016/j.ctim.2022.102820] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/23/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aims of this review were to 1) summarise the breadth and types of research regarding the impact of aquatic exercise on mental health completed to date, 2) provide a clear indication of the intervention type, volume, measurement tools used, and populations best served in relation to this activity and its effectiveness and 3) to identify domains within the literature that can be developed so recommendations can be made for future investigations. METHOD A scoping review was performed under the PRISMA guidelines. A systematic search of Pubmed, SPORTDiscus, PsycInfo and Google Scholar databases was conducted. Studies observing the effect of aquatic exercises on mental health and related parameters were considered for inclusion. The data from the selected studies were then extracted and analysed methodically. PRIMARY CONDITIONS MEASURED Depression, anxiety, mood, self-esteem, and psychological well-being were the primary mental states for which findings could be clearly extracted. RESULTS Of the 1635 articles that resulted from the search, 23 articles met all inclusion criteria. Of these, 12 were randomised controlled trials. Cumulatively, the findings of this review trend towards aquatic exercise being effective in generating positive changes in mental health. CONCLUSION Aquatic exercise, specifically winter swimming, leisure swimming, competitive swimming and aquatic aerobics, can be a promising conservative therapy for mental health management. However, it is recommended that further research be conducted to solidify these findings and establish the long-term effects of this intervention on mental health.
Collapse
Affiliation(s)
- Morgan Jackson
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland.
| | - Manjot Kang
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland
| | - James Furness
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland; Water Based Research Unit, Bond University, Gold Coast Queensland
| | - Kevin Kemp-Smith
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland; Water Based Research Unit, Bond University, Gold Coast Queensland
| |
Collapse
|
5
|
Tang Z, Wang Y, Liu J, Liu Y. Effects of aquatic exercise on mood and anxiety symptoms: A systematic review and meta-analysis. Front Psychiatry 2022; 13:1051551. [PMID: 36465296 PMCID: PMC9714032 DOI: 10.3389/fpsyt.2022.1051551] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Exercise has beneficial effects on mood and anxiety symptoms. However, the impact of aquatic exercise on mood and anxiety symptoms has not been clearly confirmed. Therefore, this study aimed to synthesize and systematically analyze evidence available on boosting mental health through aquatic exercise. METHOD A systematic review and meta-analysis were conducted under the PRISMA 2020 guidelines. PubMed, BIOSIS Previews, PsycINFO, Medline, SPORTDiscus, Education Source, and Web of Science Core Collection (WoSCC) were searched in May 2022. The research included the influence of aquatic exercises on mood and anxiety symptoms. After assessing trial quality and completing data extraction, a meta-analysis was carried out through R software. The results were presented as a standardized mean difference (SMD) and the corresponding 95% confidence interval. RESULTS A total of 18 original trials were included. People who received aquatic exercise intervention had a statistically significant reduction in mental disorder symptoms compared with before. The results were aquatic exercise [SMD = -0.77, 95% CI (-1.08, -0.47), I2 = 77%, P < 0.01], swimming [SMD = -0.51, 95% CI (-1.14, 0.12), I2 = 78%, P < 0.01], aquatic aerobics [SMD = -0.92, 95% CI (-1.32, -0.53), I2 = 78%, P < 0.01], moderate intensity [SMD = -0.75, 95% CI (-1.07, -0.43), I2 = 67%, P < 0.01], and low intensity [SMD = -1.07, 95% CI (-1.08, -0.47), I2 = 85%, P < 0.01]. CONCLUSION Aquatic exercise could statistically significantly improve mental health. Light aquatic aerobics probably has a better effect on mood and anxiety symptoms. However, given the number and quality of included research, verifying the aforementioned conclusions requires a larger sample of high-quality studies.
Collapse
Affiliation(s)
- Zhengyan Tang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Ye Wang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Jingmin Liu
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Yujie Liu
- Lang Ping Research Center for Sports Culture and Policy, Beijing Normal University, Beijing, China
| |
Collapse
|
6
|
O'Carroll GC, King SL, Carroll S, Perry JL, Vanicek N. The effects of exercise to promote quality of life in individuals with traumatic brain injuries: a systematic review. Brain Inj 2020; 34:1701-1713. [PMID: 33190557 DOI: 10.1080/02699052.2020.1812117] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To systematically review the effects of exercise interventions that may enhance quality of life (QOL) in individuals with traumatic brain injury (TBI). METHODS A systematic search was conducted using five databases up to April 2018. Studies were included if QOL was quantified following an exercise programme for people with a TBI. Methodological quality was assessed using a validated scoring checklist. Two independent reviewers assessed study inclusion and methodological quality. RESULTS Thirteen studies met the inclusion criteria (seven RCTs, six non-RCTs). The median total scores for the quality assessment tool were 26.1 (RCTs), and 21.3 (non-RCTs), out of 33. Eight out of the 13 studies reported improved QOL following an exercise programme. The duration of the interventions varied from 8-12 weeks. The most common programmes involved moderate to vigorous exercise; with a frequency and duration of 3-5 times/week for 30-60 minutes. CONCLUSION Due to the diversity of the exercise training interventions, heterogeneity of patient characteristics, multitude of QOL instruments and outcome domains assessed, it was not possible to draw any definitive conclusion about the effectiveness of exercise interventions. However, this review identified positive trends to enhance various aspects of QOL measured using a range of assessment tools.
Collapse
Affiliation(s)
- Grace C O'Carroll
- Department of Sport, Health and Exercise Science, University of Hull , Hull, UK
| | - Stephanie L King
- Department of Sport, Health and Exercise Science, University of Hull , Hull, UK
| | - Sean Carroll
- Department of Sport, Health and Exercise Science, University of Hull , Hull, UK
| | - John L Perry
- Psychology Department, Mary Immaculate College , Limerick, Republic of Ireland
| | - Natalie Vanicek
- Department of Sport, Health and Exercise Science, University of Hull , Hull, UK
| |
Collapse
|
7
|
Curcio A, Temperoni G, Tramontano M, De Angelis S, Iosa M, Mommo F, Cochi G, Formisano R. The effects of aquatic therapy during post-acute neurorehabilitation in patients with severe traumatic brain injury: a preliminary randomized controlled trial. Brain Inj 2020; 34:1630-1635. [PMID: 32991207 DOI: 10.1080/02699052.2020.1825809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The primary aim is to verify the effectiveness of an aquatic training (AT) in inpatients with severe Traumatic Brain Injury (sTBI) on balance. The secondary aims are to explore the effects on gait, activities of daily living, and quality of life, comparing to a land-based conventional protocol. METHODS Two-arm, randomized controlled trial. Twenty inpatients with sTBI, Glasgow Coma Scale score ≤8, and Level of Cognitive Functioning ≥7 were recruited and randomly assigned to the aquatic therapy group (ATG) or to the Conventional Training Group (CTG). Patients underwent 12 individual rehabilitation sessions (3 days/week, 4 weeks), in a rehabilitation pool during the post-acute intensive neurorehabilitation. The primary outcome measure was the Berg Balance Scale (BBS). Secondary outcome measures were the Modified Barthel Index (MBI), Disability Rating Scale (DRS), Tinetti Gait Balance Scale (TBG) and Quality of Life After Brain Injury (QOLIBRI). All the evaluations were performed at the baseline and after 4 weeks of training. RESULTS The within-subjects analysis showed a significant improvement both in ATG and CTG in MBI, BBS, TBG, and QOLIBRI. CONCLUSION Our results may support the use of AT during post-acute phase to improve motor functions and quality of life in patients with sTBI.
Collapse
Affiliation(s)
- A Curcio
- Fondazione Santa Lucia IRCCS , Rome, Italy
| | | | - Marco Tramontano
- Fondazione Santa Lucia IRCCS , Rome, Italy.,Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System , Rome, Italy
| | | | - M Iosa
- Fondazione Santa Lucia IRCCS , Rome, Italy
| | - F Mommo
- Fondazione Santa Lucia IRCCS , Rome, Italy
| | - G Cochi
- Fondazione Santa Lucia IRCCS , Rome, Italy
| | | |
Collapse
|
8
|
Beadle EJ, Ownsworth T, Fleming J, Shum DHK. The nature of occupational gaps and relationship with mood, psychosocial functioning and self-discrepancy after severe traumatic brain injury. Disabil Rehabil 2019; 42:1414-1422. [PMID: 30668152 DOI: 10.1080/09638288.2018.1527954] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To examine the nature of occupational gaps and desired re-engagement following severe traumatic brain injury (TBI), and the relationship to mood, self-discrepancy, and psychosocial functioning.Materials and methods: Fifty-nine adults with severe TBI (73% male, M age = 36.50, SD = 12.54) were administered measures of past, current, and desired occupations (Occupational Gaps Questionnaire), mood (Depression Stress and Anxiety Scale - 21), and self-discrepancy (Head Injury Semantic Differential Scale - version 3). Psychosocial functioning was rated by relatives on the Sydney Psychosocial Reintegration Questionnaire.Results: Participants reported that they engaged in significantly fewer occupations than prior to their injury (p < 0.001). Further, they participated in fewer occupations than they desired (p < 0.001). Desired re-engagement was identified for 18 of the 30 occupations (e.g., working, sports, managing personal finances, and supporting others). A higher number of these re-engagement gaps was significantly related to greater anxiety (r = 0.30, p < 0.05) and lower psychosocial functioning (r = -0.29, p < 0.05). A mediation analysis revealed that re-engagement gaps were indirectly related to self-discrepancy through an association with anxiety.Conclusions: Occupational gaps are commonly experienced after severe traumatic brain injury. Lack of engagement in desired occupations is associated with greater anxiety and poorer psychosocial functioning. Anxiety regarding these gaps may contribute to negative comparisons between one's pre-injury and post-injury self. Identification of occupational gaps and their psychological impact may guide the focus of client-centred rehabilitation approaches.Implications for RehabilitationGaps between current activity engagement (i.e., post injury) and desired activity engagement are commonly experienced after severe traumatic brain injury.Greater desired re-engagement gaps (i.e., when individuals report they are not completing activities that they would like to do) are associated with greater anxiety and poorer psychosocial functioning.Individuals who are unable to re-engage in desired activities are more likely to experience anxiety, which in turn may contribute to negative self-discrepancy.It may be beneficial to explore the personal meaning of changes in occupation after traumatic brain injury.
Collapse
Affiliation(s)
- Elizabeth Jane Beadle
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Mt Gravatt, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Mt Gravatt, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - David H K Shum
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Mt Gravatt, Australia.,Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
9
|
Hassett L, Moseley AM, Harmer AR. Fitness training for cardiorespiratory conditioning after traumatic brain injury. Cochrane Database Syst Rev 2017; 12:CD006123. [PMID: 29286534 PMCID: PMC6486048 DOI: 10.1002/14651858.cd006123.pub3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Reduced cardiorespiratory fitness (cardiorespiratory deconditioning) is a common consequence of traumatic brain injury (TBI). Fitness training may be implemented to address this impairment. OBJECTIVES The primary objective of this updated review was to evaluate whether fitness training improves cardiorespiratory fitness in people who have sustained a TBI. The secondary objectives were to evaluate whether fitness training improves body function and structure (physical and cognitive impairments, psychological responses resulting from the injury), activity limitations and participation restrictions in people who have sustained a TBI as well as to evaluate its safety, acceptance, feasibility and suitability. SEARCH METHODS We searched 10 electronic databases (the Cochrane Injuries Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Embase; PubMed (MEDLINE); CINAHL; AMED; SPORTDiscus; PsycINFO; PEDro and PsycBITE) and the International Clinical Trials Registry Platform for relevant trials. In addition we screened reference lists from systematic reviews related to the topic that we identified from our search, and from the included studies, and contacted trialists to identify further studies. The search was run in August 2017. SELECTION CRITERIA Randomised controlled studies with TBI participants were eligible if they compared an exercise programme incorporating cardiorespiratory fitness training to usual care, a non-exercise intervention, or no intervention. DATA COLLECTION AND ANALYSIS Two authors independently screened the search results, extracted data and assessed bias. We contacted all trialists for additional information. We calculated mean difference (MD) or standardised mean difference (SMD) and 95% confidence intervals (CI) for continuous data, and odds ratio with 95% CI for dichotomous data. We pooled data when there were sufficient studies with homogeneity. MAIN RESULTS Two new studies incorporating 96 participants were identified in this update and were added to the six previously included studies. A total of eight studies incorporating 399 participants are included in the updated review. The participants were primarily men aged in their mid-thirties who had sustained a severe TBI. No studies included children. The studies were clinically diverse with regard to the interventions, time postinjury and the outcome measures used. At the end of intervention, the mean difference in peak power output was 35.47 watts (W) in favour of fitness training (MD 35.47 W, 95% CI 2.53 to 68.41 W; 3 studies, 67 participants; low-quality evidence). The CIs include both a possible clinically important effect and a possible negligible effect, and there was moderate heterogeneity among the studies.Five of the secondary outcomes had sufficient data at the end of intervention to enable meta-analysis: body composition (SMD 0.29 standard deviations (favouring control), 95% CI -0.22 to 0.79; 2 studies, 61 participants; low-quality evidence), strength (SMD -0.02 (favouring control), 95% CI -0.86 to 0.83; 2 studies, 23 participants; very low-quality evidence), fatigue (SMD -0.32 (favouring fitness training), 95% CI -0.90 to 0.26; 3 studies, 130 participants; very low-quality evidence), depression (SMD -0.43 (favouring fitness training), 95% CI -0.92 to 0.06; 4 studies, 220 participants; very low-quality evidence), and neuromotor function (MD 0.01 m (favouring fitness training), 95% CI -0.25 to 0.27; 2 studies, 109 participants; moderate-quality evidence). It was uncertain whether fitness training was more or less effective at improving these secondary outcomes compared to the control interventions. Quality of life was assessed in three trials, but we did not pool the data because of substantial heterogeneity. Five of the eight included studies had no dropouts from their intervention group and no adverse events were reported in any study. AUTHORS' CONCLUSIONS There is low-quality evidence that fitness training is effective at improving cardiorespiratory deconditioning after TBI; there is insufficient evidence to draw any definitive conclusions about the other outcomes. Whilst the intervention appears to be accepted by people with TBI, and there is no evidence of harm, more adequately powered and well-designed studies are required to determine a more precise estimate of the effect on cardiorespiratory fitness, as well as the effects across a range of important outcome measures and in people with different characteristics (e.g. children). In the absence of high quality evidence, clinicians may be guided by pre-exercise screening checklists to ensure the person with traumatic brain injury is safe to exercise, and set training parameters using guidelines established by the American College of Sports Medicine for people who have suffered a brain injury.
Collapse
Affiliation(s)
- Leanne Hassett
- The University of SydneyDiscipline of Physiotherapy, Faculty of Health Sciences and Musculoskeletal Health Sydney, School of Public HealthSydneyAustralia
| | - Anne M Moseley
- School of Public Health, The University of SydneyMusculoskeletal Health SydneyPO Box M179Missenden RdSydneyNSWAustralia2050
| | - Alison R Harmer
- The University of SydneyFaculty of Health SciencesC42 ‐ Cumberland CampusRoom 208, O BlockSydneyNew South WalesAustraliaNSW 1825
| | | |
Collapse
|
10
|
Driver S, Reynolds M, Kramer K. Modifying an evidence-based lifestyle programme for individuals with traumatic brain injury. Brain Inj 2017; 31:1612-1616. [DOI: 10.1080/02699052.2017.1346286] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Simon Driver
- Department of Physical Medicine and Rehabilitation, Baylor Institute for Rehabilitation, Baylor University Medical Center, Dallas, TX, USA
| | - Megan Reynolds
- Department of Physical Medicine and Rehabilitation, Baylor Institute for Rehabilitation, Baylor University Medical Center, Dallas, TX, USA
| | - Kaye Kramer
- Innovative Wellness Solutions, LLC, Pittsburgh, PA, USA
| |
Collapse
|
11
|
Driver S, Woolsey A. Evaluation of a Physical Activity Behavior Change Program for Individuals With a Brain Injury. Arch Phys Med Rehabil 2016; 97:S194-200. [DOI: 10.1016/j.apmr.2015.06.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 04/28/2015] [Accepted: 06/23/2015] [Indexed: 01/09/2023]
|
12
|
Chang PFJ, Baxter MF, Rissky J. Effectiveness of Interventions Within the Scope of Occupational Therapy Practice to Improve Motor Function of People With Traumatic Brain Injury: A Systematic Review. Am J Occup Ther 2016; 70:7003180020p1-5. [PMID: 27089286 DOI: 10.5014/ajot.2016.020867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
After traumatic brain injury (TBI), many people experience significant motor function impairments. To help occupational therapy practitioners make informed decisions in choosing treatment strategies to improve clients' motor function, we undertook a systematic review and synthesized applicable findings of intervention studies. Of 2,306 articles identified in the literature search, we reviewed 47 full-text articles, of which 16 met approved criteria. We found moderate evidence that various exercise programs increase motor function and limited evidence that people with TBI can benefit from rehabilitation and computer-based programs. We offer implications for practice, education, and research.
Collapse
Affiliation(s)
- Pei-Fen J Chang
- Pei-Fen J. Chang, PhD, OTR, is Associate Professor, School of Occupational Therapy, Texas Woman's University, Houston;
| | - Mary Frances Baxter
- Mary Frances Baxter, PhD, OT, FAOTA, is Associate Professor, School of Occupational Therapy, Texas Woman's University, Houston
| | - Jenna Rissky
- Jenna Rissky, MOT, was Graduate Student, Texas Woman's University, Houston, at the time of the study
| |
Collapse
|
13
|
Goverover Y, Genova H, Smith A, Chiaravalloti N, Lengenfelder J. Changes in activity participation following traumatic brain injury. Neuropsychol Rehabil 2016; 27:472-485. [PMID: 27043964 DOI: 10.1080/09602011.2016.1168746] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Traumatic brain injury (TBI) often results in impairments in cognitive skills as well as depression. As a result of these changes in cognition and mood, individuals with TBI may reduce their levels of participation and often report reduced health-related quality of life (HrQOL). The current study compares levels of past and present activity participation between healthy participants and persons with TBI using a client-centred approach in measurement. We additionally examine the relationship between activity participation, emotional functioning and HrQOL in persons with TBI. Fifty-two individuals with TBI who live in the community and 30 healthy age-matched controls performed a battery of cognitive tests and rated their affective symptomatology and activity participation (using the Activity Card Sort Test). Participants with TBI reported significantly lower current activity participation compared to controls. Current levels of activity and participation in the TBI sample were significantly related to age, time since injury, and HrQOL. Additionally, depressive symptomatology was significantly associated with HrQOL, but not with activity participation. Following TBI, levels of activity participation are reduced in most aspects of life, but more profoundly in social activities, high demand leisure activities and household activities. Additionally, high levels of depressive symptoms are associated with negative reports of HrQOL, regardless of current levels of activity participation.
Collapse
Affiliation(s)
- Yael Goverover
- a Department of Occupational Therapy , New York University , New York , NY , USA.,b Kessler Foundation , West Orange , NJ , USA
| | - Helen Genova
- b Kessler Foundation , West Orange , NJ , USA.,c Department of Physical Medicine and Rehabilitation , New Jersey Medical School, Rutgers University , Newark , NJ , USA
| | | | - Nancy Chiaravalloti
- b Kessler Foundation , West Orange , NJ , USA.,c Department of Physical Medicine and Rehabilitation , New Jersey Medical School, Rutgers University , Newark , NJ , USA
| | - Jeanie Lengenfelder
- b Kessler Foundation , West Orange , NJ , USA.,c Department of Physical Medicine and Rehabilitation , New Jersey Medical School, Rutgers University , Newark , NJ , USA
| |
Collapse
|
14
|
Patterson F, Fleming J, Doig E. Group-based delivery of interventions in traumatic brain injury rehabilitation: a scoping review. Disabil Rehabil 2016; 38:1961-86. [DOI: 10.3109/09638288.2015.1111436] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Freyr Patterson
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Jennifer Fleming
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health District, Queensland Health, Brisbane, Australia
| | - Emmah Doig
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health District, Queensland Health, Brisbane, Australia
| |
Collapse
|
15
|
Vieira CE, Fiamenghi-Jr GA, Blascovi-Assis SM, Bartholomeu D, Montiel JM. Stress Reduction in Chronic Patients’ Professional Carers Through Hydrotherapy. PSYCHOLOGY, COMMUNITY & HEALTH 2015. [DOI: 10.5964/pch.v4i3.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo Cuidadoras em trabalho institucional para pessoas com deficiências profundas exercem atividades fundamentais, mas desgastantes, observadas constantemente por todos os memberos da instituição (diretores, funcionários e até voluntários), provocando altos níveis de stress. O objetivo foi realizar uma atividade que reduza o stress em cuidadoras de pacientes crónicos institucionalizados. Método Participaram 11 cuidadoras formais de uma instituição residencial para atendimento de pessoas com paralisia cerebral severa, que responderam ao Inventário de Sintomas de Stress para Adultos de Lipp – ISSL, antes e após sessões de hidroterapia semanais. Resultados Os resultados demostraram que todas as participantes apresentaram elevado grau de stress antes das sessões e houve redução dos sintomas na maioria das participantes após a hidroterapia. São discutidas as necessidades destas profissionais com formação escolar básica, sem cursos técnicos e muito exigidas pelas instituições. Conclusão Quanto melhores forem as suas condições de trabalho, melhor será a sua relação com os assistidos, que são os motivos reais da existência das instituições.
Collapse
|
16
|
Hamilton M, Williams G, Bryant A, Clark R, Spelman T. Which factors influence the activity levels of individuals with traumatic brain injury when they are first discharged home from hospital? Brain Inj 2015; 29:1572-80. [DOI: 10.3109/02699052.2015.1075145] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
17
|
Ownsworth T, Haslam C. Impact of rehabilitation on self-concept following traumatic brain injury: An exploratory systematic review of intervention methodology and efficacy. Neuropsychol Rehabil 2014; 26:1-35. [DOI: 10.1080/09602011.2014.977924] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
18
|
Review of the Status of Physical Activity Research for Individuals With Traumatic Brain Injury. Arch Phys Med Rehabil 2013; 94:1184-9. [DOI: 10.1016/j.apmr.2013.01.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 12/19/2012] [Accepted: 01/07/2013] [Indexed: 11/19/2022]
|
19
|
A health and wellness intervention for those with moderate to severe traumatic brain injury: a randomized controlled trial. J Head Trauma Rehabil 2013; 27:E57-68. [PMID: 23131971 DOI: 10.1097/htr.0b013e318273414c] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the efficacy of a standardized 12-week health and wellness group intervention for those with moderate to severe traumatic brain injury (TBI). STUDY DESIGN Randomized controlled trial. PARTICIPANTS Seventy-four individuals with moderate to severe TBI recruited from the outpatient program at a rehabilitation hospital, a Veterans Affairs Medical Center, and the community. METHOD Eligible participants were randomized to treatment (health and wellness therapy group) or wait-list control (treatment, n = 37; wait-list, n = 37). The primary outcome was the Health Promoting Lifestyle Profile-II. RESULTS The results of the mixed-model repeated-measures analysis indicated no differences between treatment and control groups engaging in activities to increase their health and well-being. CONCLUSIONS Findings did not support the efficacy of the intervention. Results may have been impacted by the wide variability of individualized health and wellness goals selected by group members, the structure and/or content of the group, and/or the outcome measures selected.
Collapse
|
20
|
Braden CA, Cuthbert JP, Brenner L, Hawley L, Morey C, Newman J, Staniszewski K, Harrison-Felix C. Health and wellness characteristics of persons with traumatic brain injury. Brain Inj 2012; 26:1315-27. [DOI: 10.3109/02699052.2012.706351] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
21
|
Cunningham C, Wensley R, Blacker D, Bache J, Stonier C. Occupational Therapy to Facilitate Physical Activity and Enhance Quality of Life for Individuals with Complex Neurodisability. Br J Occup Ther 2012. [DOI: 10.4276/030802212x13286281651234] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This critical reflection on practice uses case study examples from the Royal Hospital for Neuro-disability (RHN), a national medical charity, to illustrate the importance of meaningful physical activity and the challenges faced when facilitating this for individuals with complex neurodisability. It demonstrates the role that occupational therapists play, and the importance of multidisciplinary team working to enable these individuals to return to activities and roles that are personally fulfilling. Finally, it challenges the traditional view of physical activity, highlighting the benefits in terms of facilitating a positive self-identity, providing an opportunity for choice and control, promoting social interaction and enhancing quality of life.
Collapse
Affiliation(s)
- Crystal Cunningham
- Formerly Senior II Occupational Therapist, Occupational Therapy Department, Royal Hospital for Neuro-disability, London, and now Senior II Occupational Therapist, Occupational Therapy Department, East Surrey Hospital, Redhill, Surrey
| | - Ruth Wensley
- Senior II Occupational Therapist, Occupational Therapy Department, Royal Hospital for Neuro-disability, London
| | - Danielle Blacker
- Clinical Specialist Occupational Therapist, Occupational Therapy Department, Royal Hospital for Neuro-disability, London
| | - Jane Bache
- Joint Head of Assistive and Rehabilitation Technology, COMPASS/Assistive Technology Service, Royal Hospital for Neuro-disability, London
| | - Claire Stonier
- Head of Recreation and Leisure Service, Royal Hospital for Neuro-disability, London
| |
Collapse
|
22
|
Driver S, Ede A, Dodd Z, Stevens L, Warren AM. What barriers to physical activity do individuals with a recent brain injury face? Disabil Health J 2011; 5:117-25. [PMID: 22429546 DOI: 10.1016/j.dhjo.2011.11.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 11/10/2011] [Accepted: 11/14/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Traumatic brain injury (TBI) is a serious public health issue that challenges professionals to develop effective health promotion strategies to meet individual's diverse and unique needs. One effective health promotion strategy is physical activity (PA), although barriers to activity frequently prevent participation. Thus, there is a need to identify the barriers to participation, amount of weekly PA completed, and readiness to be active if effective health promotion programs are to be implemented. METHODS A convenience sample of 28 outpatients with a TBI completed a questionnaire before discharge from a comprehensive outpatient program and descriptive statistics were reported. In addition independent t tests and effect sizes were calculated between amount of PA and stage of change. RESULTS Our results indicated that participants only faced an average of 2.25 barriers (range 0-9), completed a mean of 46 minutes of PA each week, and reported being in the "action" stage of PA participation. Individuals in the action and maintenance stage completed significantly more PA (21.67; t [25] = -15.43; p < .001; Cohen's D effect size = 4.39) than precontemplators or contemplators. CONCLUSIONS Individuals with a TBI face many different barriers that prevent them from being active, placing them at further risk of experiencing secondary and chronic conditions. Practitioners should acknowledge that each individual faces a unique set of barriers emphasizing the importance of individualized health promotion programs.
Collapse
Affiliation(s)
- Simon Driver
- School of Biological and Population Health, Oregon State University, Corvallis, OR 97331, USA.
| | | | | | | | | |
Collapse
|
23
|
Fenech A. Aquatic Leisure satisfaction and engagement in Neuropalliative Disability Management. Scand J Caring Sci 2011; 26:519-27. [DOI: 10.1111/j.1471-6712.2011.00958.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
24
|
White GW, Gonda C, Peterson JJ, Drum CE. Secondary analysis of a scoping review of health promotion interventions for persons with disabilities: Do health promotion interventions for people with mobility impairments address secondary condition reduction and increased community participation? Disabil Health J 2011; 4:129-39. [DOI: 10.1016/j.dhjo.2010.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Revised: 04/03/2010] [Accepted: 05/10/2010] [Indexed: 10/19/2022]
|
25
|
Reavenall S, Blake H. Determinants of physical activity participation following traumatic brain injury. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2010. [DOI: 10.12968/ijtr.2010.17.7.48893] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sarah Reavenall
- University Hospitals Birmingham NHS Foundation Trust, Burns Centre, New Queen Elizabeth Hospital Birmingham; and
| | - Holly Blake
- Division of Nursing, Faculty of Medicine and Health Sciences, Queen's Medical Centre, Nottingham, UK
| |
Collapse
|
26
|
|
27
|
Devine JM, Zafonte RD. Physical exercise and cognitive recovery in acquired brain injury: a review of the literature. PM R 2009; 1:560-75. [PMID: 19627946 DOI: 10.1016/j.pmrj.2009.03.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Revised: 02/05/2009] [Accepted: 03/29/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Physical exercise has been shown to play an ever-broadening role in the maintenance of overall health and has been implicated in the preservation of cognitive function in both healthy elderly and demented populations. Animal and human studies of acquired brain injury (ABI) from trauma or vascular causes also suggest a possible role for physical exercise in enhancing cognitive recovery. DATA SOURCES A review of the literature was conducted to explore the current understanding of how physical exercise impacts the molecular, functional, and neuroanatomic status of both intact and brain-injured animals and humans. STUDY SELECTION Searches of the MEDLINE, CINHAL, and PsychInfo databases yielded an extensive collection of animal studies of physical exercise in ABI. Animal studies strongly tie physical exercise to the upregulation of multiple neural growth factor pathways in brain-injured animals, resulting in both hippocampal neurogenesis and functional improvements in memory. DATA EXTRACTION A search of the same databases for publications involving physical exercise in human subjects with ABI yielded 24 prospective and retrospective studies. DATA SYNTHESIS Four of these evaluated cognitive outcomes in persons with ABI who were involved in physical exercise. Three studies cited a positive association between exercise and improvements in cognitive function, whereas one observed no effect. Human exercise interventions varied greatly in duration, intensity, and level of subject supervision, and tools for assessing neurocognitive changes were inconsistent. CONCLUSIONS There is strong evidence in animal ABI models that physical exercise facilitates neurocognitive recovery. Physical exercise interventions are safe in the subacute and rehabilitative phases of recovery for humans with ABI. In light of strong evidence of positive effects in animal studies, more controlled, prospective human interventions are warranted to better explore the neurocognitive effects of physical exercise on persons with ABI.
Collapse
Affiliation(s)
- Jennifer M Devine
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
28
|
|
29
|
Blake H, Batson M. Exercise intervention in brain injury: a pilot randomized study of Tai Chi Qigong. Clin Rehabil 2009; 23:589-98. [PMID: 19237436 DOI: 10.1177/0269215508101736] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the effects of a brief Tai Chi Chuan Qigong ('Qigong') exercise intervention on individuals with traumatic brain injury. DESIGN A single-centre randomized controlled trial pilot study. SETTING A registered charity day centre in the community. SUBJECTS Twenty individuals with traumatic brain injury. INTERVENTION Intervention participants attended a Qigong exercise session for one hour per week over eight weeks. Control participants engaged in non-exercise-based social and leisure activities for the same intervention period. MEASURES Outcome was assessed at baseline and post intervention using the General Health Questionnaire-12, the Physical Self-Description Questionnaire and the Social Support for Exercise Habits Scale, to measure perceived mood, self-esteem, flexibility, coordination, physical activity and social support. RESULTS Groups were comparable at baseline. After the intervention, mood was improved in the exercise group when compared with controls (U = 22.0, P =0.02). Improvements in self-esteem (Z = 2.397, P =0.01) and mood (Z = -2.032, P =0.04) across the study period were also evident in the exercise group only. There were no significant differences in physical functioning between groups. In view of the sample size, these findings are inconclusive. CONCLUSIONS This study provides preliminary evidence that a brief Qigong exercise intervention programme may improve mood and self-esteem for individuals with traumatic brain injury. This needs to be tested in a large-scale randomized trial.
Collapse
Affiliation(s)
- H Blake
- University of Nottingham School of Nursing, Midwifery & Physiotherapy, Queen's Medical Centre, Nottingham NG7 2AH, UK.
| | | |
Collapse
|
30
|
Dong Koog Noh, Lim JY, Shin HI, Paik NJ. The effect of aquatic therapy on postural balance and muscle strength in stroke survivors — a randomized controlled pilot trial. Clin Rehabil 2008; 22:966-76. [DOI: 10.1177/0269215508091434] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To evaluate the effect of an aquatic therapy programme designed to increase balance in stroke survivors. Design: A randomized, controlled pilot trial. Setting: Rehabilitation department of a university hospital. Subjects: Ambulatory chronic stroke patients (n = 25):13 in an aquatic therapy group and 12 in a conventional therapy group. Interventions: The aquatic therapy group participated in a programme consisting of Ai Chi and Halliwick methods, which focused on balance and weight-bearing exercises. The conventional therapy group performed gym exercises. In both groups, the interventions occurred for 1 hour, three times per week, for eight weeks. Main measures: The primary outcome measures were Berg Balance Scale score and weight-bearing ability, as measured by vertical ground reaction force during four standing tasks (rising from a chair and weight-shifting forward, backward and laterally). Secondary measures were muscle strength and gait. Results: Compared with the conventional therapy group, the aquatic therapy group attained significant improvements in Berg Balance Scale scores, forward and backward weight-bearing abilities of the affected limbs, and knee flexor strength (P<0.05), with effect sizes of 1.03, 1.14, 0.72 and 1.13 standard deviation units and powers of 75, 81, 70 and 26%, respectively. There were no significant changes in the other measures between the two groups. Conclusions: Postural balance and knee flexor strength were improved after aquatic therapy based on the Halliwick and Ai Chi methods in stroke survivors. Because of limited power and a small population base, further studies with larger sample sizes are required.
Collapse
Affiliation(s)
- Dong Koog Noh
- Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - Jae-Young Lim
- Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea, ,
| | - Hyung-Ik Shin
- Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - Nam-Jong Paik
- Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| |
Collapse
|
31
|
Hassett LM, Moseley AM, Tate R, Harmer AR. Fitness training for cardiorespiratory conditioning after traumatic brain injury. Cochrane Database Syst Rev 2008:CD006123. [PMID: 18425937 DOI: 10.1002/14651858.cd006123.pub2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cardiorespiratory deconditioning is a common sequelae after traumatic brain injury (TBI). Clinically, fitness training is implemented to address this impairment, however this intervention has not been subject to rigorous review. OBJECTIVES The primary objective was to evaluate whether fitness training improves cardiorespiratory fitness in people who have sustained a TBI. SEARCH STRATEGY We searched ten electronic databases (Cochrane Injuries Group Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); EMBASE; PubMed (MEDLINE); CINAHL; AMED; SPORTDiscus; PsycINFO; PEDro and PsycBITE) and two clinical trials registers (TrialsCentral and Current Controlled Trials). The last search was August 2007. In addition we screened reference lists from included studies and contacted trialists to identify further studies. SELECTION CRITERIA Randomised controlled studies with TBI participants were eligible if they compared an exercise programme incorporating cardiorespiratory fitness training to usual care, a non-exercise intervention or no intervention. DATA COLLECTION AND ANALYSIS Two authors independently screened the search output, extracted data and assessed quality. All trialists were contacted for additional information. Mean difference and 95% confidence intervals (CI) were calculated for continuous data and risk difference or odds ratio and 95% CI were calculated for dichotomous data. Data were pooled when there were sufficient studies with clinical and statistical homogeneity. MAIN RESULTS Six studies, incorporating 303 participants, were included. The participants were primarily males, in their mid thirties who had sustained a severe TBI. The studies were clinically diverse with regard to the interventions, time post-injury and the outcome measures used; therefore, the primary outcome could not be pooled. Three of the six studies indirectly assessed change in cardiorespiratory fitness after fitness training using the peak power output obtained during cycle ergometry (either at volitional fatigue or at a predetermined endpoint, that is, a percentage of predicted heart rate maximum). Cardiorespiratory fitness was improved after fitness training in one study (mean difference 59 watts, 95% CI 24 to 94), whilst there was no significant improvement in the other two studies. Four of the six studies had no drop-outs from their intervention group and no adverse events were reported in any study. AUTHORS' CONCLUSIONS There is insufficient evidence to draw any definitive conclusions about the effects of fitness training on cardiorespiratory fitness. Whilst it appears to be a safe and accepted intervention for people with TBI, more adequately powered and well-designed studies are required to determine the effects across a range of outcome measures.
Collapse
Affiliation(s)
- L M Hassett
- Liverpool Health Service, Brain Injury Rehabilitation Unit, Locked Bag 7103, Liverpool BC, NSW, Australia, 1871.
| | | | | | | |
Collapse
|
32
|
Maki AL, Rudrud EH, Schulze KA, Rapp JT. Increasing therapeutic exercise participation by individuals with acquired brain injury using self-recording and reinforcement. BEHAVIORAL INTERVENTIONS 2008. [DOI: 10.1002/bin.255] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|