A home-based walking study to ameliorate perceived stress and depressive symptoms in people with a traumatic brain injury

Abstract

Objective: To determine whether a 12-week home-based walking programme can decrease perceived stress and depressive symptoms in persons with a traumatic brain injury (TBI).

Setting: Community- and home-based.

Participants: Sixty-nine participants with a TBI.

Design: Comparative effectiveness cross-over design with random assignment to treatment sequence and blinded post-hoc assessment of outcome where participants completed a 12-week walking intervention and a nutrition education module. The walking intervention utilized pedometers to track the amount of steps each participant walked daily. With the assistance of an assigned coach, weekly goals were given with the intent of increasing the amount of walking that the participant was initially completing. The nutrition control group was created to offset the impact of the coaching calls.

Main measures: Measurement of perceived stress and depressive symptoms was completed through the use of the Perceived Stress Scale (PSS) and Center for Epidemiological Studies-Depression (CES-D). These measures were collected at three time points: baseline and following each 12-week intervention.

Results: Results indicated that both perceived stress and depression symptoms significantly improved following the walking intervention.

Conclusions: While limitations existed with the study, it is evident that walking can be used as an efficient and cost-effective tool to manage perceived stress and depressive symptoms in persons who have sustained a TBI.

• Coaching
• depression
• exercise
• nutrition
• physical activity
• stress
• traumatic brain injury
• walking

Acknowledgements

We would like to thank the physical therapists, Cheryl Sidel, Michelle Unger and Stephanie Ciccarella, who assisted us to safely assess each participant who participated in the study. Additionally we would like to thank Christine Hagion Rzepka, MPH, CHES for her editorial and statistical assistance with the revision of the initial manuscript. Last, but and most certainly not least, we would like to thank the study participants; without whom we could not have attempted or completed this work.

Declaration of interest

This research was supported by grants 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 (H133A070038).