title: 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.
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA.|b Brain Trauma Foundation , New York, NY and Campbell, CA , USA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Kolakowsky-Hayner
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Bellon
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA.
authors.forename: Ketra
authors.initials: K
authors.lastname: Toda
authors.affiliation: c NYU Langone School of Medicine , Rusk Institute for Rehabilitation Medicine , New York , NY , USA.
authors.forename: Tamara
authors.initials: T
authors.lastname: Bushnik
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA.
authors.forename: Jerry
authors.initials: J
authors.lastname: Wright
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Isaac
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Santa Clara Valley Medical Center , San Jose , CA , USA.|d Division of Physical Medicine and Rehabilitation in Department of Orthopedic Surgery , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Englander
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000534:rehabilitation*; D018592:Cross-Over Studies; D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D016037:Single-Blind Method; D016138:Walking / Q000502:physiology*
keywords: Traumatic brain injury; fatigue; physical activity; walking