Traumatic Brain Injury Modifies the Relationship Between Physical Activity and Global and Cognitive Health: Results From the Barcelona Brain Health Initiative.

Timothy P Morris,Javier Solana-Sánchez,Gabriele Cattaneo,Jose-Maria Tormos Muñoz,David Bartrés-Faz,Alvaro Pascual-Leone

doi:10.3389/fnbeh.2019.00135

Abstract

Physical activity has many health benefits for individuals with and without history of brain injury. Here, we evaluated in a large cohort study the impact of physical activity on global and cognitive health as measured by the PROMIS global health and NeuroQoL cognitive function questionnaires. A nested case control study assessed the influence of a history of traumatic brain injury (TBI) on the effects of physical activity since underlying pathophysiology and barriers to physical activity in individuals with TBI may mean the effects of physical activity on perceived health outcomes differ compared to the general population. Those with a history of TBI (n = 81) had significantly lower Global health (β = −1.66, p = 0.010) and NeuroQoL cognitive function (β = −2.65, p = 0.006) compared to healthy adults (n = 405). A similar proportion of individuals in both groups reported being active compared to being insufficiently active ( = 0.519 p = 0.471). Furthermore, the effect of physical activity on global health (β = 0.061, p = 0.076) and particularly for NeuroQoL (β = 0.159, p = 0.002) was greater in those with a history of TBI. Individuals with a history of TBI can adhere to a physically active lifestyle, and if so, that is associated with higher global and cognitive health perceptions. Adhering to a physically active lifestyle is non-trivial, particularly for individuals with TBI, and therefore adapted strategies to increase participation in physical activity is critical for the promotion of public health.

Highlights

Physical activity is associated with a 20%–30% lower risk in all-cause mortality and incidence of multiple chronic conditions (James et al, 2016)
Using the leisure score index (LSI) cut-off scores to classify participants into active and insufficiently active, a similar proportion of those with and without and history of traumatic brain injury (TBI) were classified as active (X(21) = 0.519 p = 0.471), compared to insufficiently active (Figure 1)
Physical activity level significantly predicted Promis global health (β = 0.049, SE = 0.011, p ≤ 0.001, 95% CI’s = 0.027, 0.071)

Summary

Introduction

Physical activity is associated with a 20%–30% lower risk in all-cause mortality and incidence of multiple chronic conditions (James et al, 2016). The effects span multiple bodily systems from cardiovascular benefits (James et al, 2016) to mental health (Blumenthal et al, 1999; Babyak et al, 2000) and cognitive function (Colcombe and Kramer, 2003; Gomes-Osman et al, 2018; Northey et al, 2018). The effects of physical activity on cognitive function has received particular attention in recent decades across distinct age groups, including adolescents (Donnelly et al, 2016), older adults (Colcombe and Kramer, 2003) and patients with dementia (Gomes-Osman et al, 2018). Physical inactivity is exacerbated in those with a disability, with almost half of US adults with a disability being physically inactive and having a greater likelihood of having a chronic disease (Carroll et al, 2014)

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