A randomised control trial of walking to ameliorate brain injury fatigue: a NIDRR TBI model system centre-based study

ABSTRACT

Fatigue is one of the most commonly reported sequelae after traumatic brain injury (TBI). This study evaluated the impact of a graduated physical activity programme on fatigue after TBI. Using a prospective randomised single-blind crossover design, 123 individuals with TBI, over the age of 18, were enrolled. Interventions included a home-based walking programme utilising a pedometer to track daily number of steps at increasing increments accompanied by tapered coaching calls over a 12-week period. Nutritional counselling with the same schedule of coaching calls served as the control condition. Main outcome measures included: the Global Fatigue Index (GFI), the Barrow Neurological Institute (BNI) Fatigue Scale Overall Severity Index Score, and the Multidimensional Fatigue Inventory (MFI). Step counts improved over time regardless of group assignment. The walking intervention led to a decrease in GFI, BNI Total, and MFI General scores. Participants reported less fatigue at the end of the active part of the intervention (24 weeks) and after a wash out period (36 weeks) as measured by the BNI Overall. The study suggests that walking can be used as an efficient and cost-effective tool to improve fatigue in persons who have sustained a TBI.

KEYWORDS:

• Traumatic brain injury
• fatigue
• walking
• physical activity

Acknowledgements

Cynthia Castro, PhD, assisted with the study design. Physical therapists, Cheryl Sidel, Michelle Unger and Stephanie Ciccarella assessed participants for safety of participation. Sam Watcha served as a statistical intern on the project. Finally the authors would like to acknowledge the participants without whom the study could not have been successfully completed.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was funded primarily from a grant from the National Institute on Disability and Rehabilitation Research, Office of Special Education and Rehabilitative Services, US Department of Education TBI Model Systems Grant to Santa Clara Valley Medical Center [grant number H133A070038].