Meta-Analysis

. 2023 Jan 9;23(1):63.

doi: 10.1186/s12889-022-14935-7.

The effect of physical activity on health outcomes in people with moderate-to-severe traumatic brain injury: a rapid systematic review with meta-analysis

Liam Johnson^{1

2}, Gavin Williams^{1

3}, Catherine Sherrington^{4

5}, Kavya Pilli⁶, Sakina Chagpar⁵, Aylish Auchettl³, Jack Beard³, Renee Gill³, Gabrielle Vassallo⁷, Nick Rushworth⁸, Sean Tweedy⁹, Grahame Simpson^{6

10}, Adam Scheinberg^{11

12}, Kelly Clanchy^{13

14}, Anne Tiedemann^{4

5}, Leanne Hassett^{15

16

17}

Affiliations

¹ School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
² School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia.
³ Physiotherapy Department, Epworth HealthCare, Melbourne, Australia.
⁴ Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
⁵ Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.
⁶ Liverpool Brain Injury Rehabilitation Unit, South Western Sydney Local Health District, Sydney, Australia.
⁷ Consumer representative, Sydney, Australia.
⁸ Brain Injury Australia, Sydney, Australia.
⁹ School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia.
¹⁰ 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.
¹¹ Murdoch Children's Research Institute, Melbourne, Australia.
¹² School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
¹³ School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Australia.
¹⁴ Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia.
¹⁵ Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia. leanne.hassett@sydney.edu.au.
¹⁶ Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. leanne.hassett@sydney.edu.au.
¹⁷ The University of Sydney, Susan Wakil Health Building, D19 Western Ave, Camperdown, NSW, 2006, Australia. leanne.hassett@sydney.edu.au.

PMID: 36624502
PMCID: PMC9830875
DOI: 10.1186/s12889-022-14935-7

Meta-Analysis

The effect of physical activity on health outcomes in people with moderate-to-severe traumatic brain injury: a rapid systematic review with meta-analysis

Liam Johnson et al. BMC Public Health. 2023.

. 2023 Jan 9;23(1):63.

doi: 10.1186/s12889-022-14935-7.

Authors

Affiliations

¹ School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
² School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia.
³ Physiotherapy Department, Epworth HealthCare, Melbourne, Australia.
⁴ Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
⁵ Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.
⁶ Liverpool Brain Injury Rehabilitation Unit, South Western Sydney Local Health District, Sydney, Australia.
⁷ Consumer representative, Sydney, Australia.
⁸ Brain Injury Australia, Sydney, Australia.
⁹ School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia.
¹⁰ 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.
¹¹ Murdoch Children's Research Institute, Melbourne, Australia.
¹² School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
¹³ School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Australia.
¹⁴ Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia.
¹⁵ Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia. leanne.hassett@sydney.edu.au.
¹⁶ Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. leanne.hassett@sydney.edu.au.
¹⁷ The University of Sydney, Susan Wakil Health Building, D19 Western Ave, Camperdown, NSW, 2006, Australia. leanne.hassett@sydney.edu.au.

PMID: 36624502
PMCID: PMC9830875
DOI: 10.1186/s12889-022-14935-7

Erratum in

Correction to: the effect of physical activity on health outcomes in people with moderate-to-severe traumatic brain injury: a rapid systematic review with meta-analysis.
Johnson L, Williams G, Sherrington C, Pilli K, Chagpar S, Auchett A, Beard J, Gil R, Vassallo G, Rushworth N, Tweedy S, Simpson G, Scheinberg A, Clanchy K, Tiedemann A, Hassett L. Johnson L, et al. BMC Public Health. 2023 Mar 6;23(1):433. doi: 10.1186/s12889-023-15240-7. BMC Public Health. 2023. PMID: 36879239 Free PMC article. No abstract available.

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.

Keywords: Disability; Meta-analysis; Physical activity; Rapid review; Traumatic brain injury.

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Conflict of interest statement

None declared.

Figures

**Fig. 1**
Results of a systematic search process [60]

**Fig. 2**
Meta-analysis of effect of a physical activity intervention on measures of composite mobility and walking. This figure presents a meta-analysis of the effect of a physical intervention vs. A a physical activity intervention with different parameters on a composite mobility measure; (B) no intervention on walking velocity

**Fig. 3**
Meta-analysis of effect of physical activity intervention on balance, cardiorespiratory fitness and body composition measures. This figure presents a meta-analysis of the effect of a physical activity intervention vs. A a physical activity intervention with different parameters on balance; (B) a non-physical activity intervention or no additional intervention on cardiorespiratory fitness; (C) a non-physical activity intervention on body composition

**Fig. 4**
Meta-analysis of effect of physical activity intervention on measures of fatigue and quality of life. This figure presents a meta-analysis of the effect of a physical activity intervention vs. A a non-physical activity intervention on fatigue; (B) a non-physical activity intervention or no intervention on quality of life

**Fig. 5**
Meta-analysis of the effect of a physical activity intervention on measures of mood. This figure presents a meta-analysis of the effect of a physical activity intervention vs. A a non-physical activity intervention on mood; (B) no intervention on mood

See this image and copyright information in PMC

References

1. Gardner AJ, Zafonte R. Neuroepidemiology of traumatic brain injury. Handb Clin Neurol. 2016;138:207–23. doi: 10.1016/B978-0-12-802973-2.00012-4. - DOI - PubMed
1. Johnson WD, Griswold DP. Traumatic brain injury: a global challenge. Lancet Neurol. 2017;16(12):949–50. doi: 10.1016/S1474-4422(17)30362-9. - DOI - PubMed
1. Pozzato I, Tate RL, Rosenkoetter U, Cameron ID. Epidemiology of hospitalised traumatic brain injury in the state of New South Wales, Australia: a population-based study. Aust N Z J Public Health. 2019;43(4):382–8. doi: 10.1111/1753-6405.12878. - DOI - PubMed
1. Bramlett HM, Dietrich WD. Long-term consequences of traumatic brain injury: current status of potential mechanisms of injury and neurological outcomes. J Neurotrauma. 2015;32(23):1834–48. doi: 10.1089/neu.2014.3352. - DOI - PMC - PubMed
1. Hamel RN, Smoliga JM. Physical activity intolerance and cardiorespiratory dysfunction in patients with moderate-to-severe traumatic brain injury. Sports Med. 2019;49(8):1183–98. doi: 10.1007/s40279-019-01122-9. - DOI - PubMed

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The effect of physical activity on health outcomes in people with moderate-to-severe traumatic brain injury: a rapid systematic review with meta-analysis

Affiliations

The effect of physical activity on health outcomes in people with moderate-to-severe traumatic brain injury: a rapid systematic review with meta-analysis

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical