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Pediatric Traumatic Brain Injury and Exercise Medicine: A Narrative Review

Bhanu Sharma and Brian W. Timmons

The recent increase in scientific activity related to traumatic brain injury (TBI)—and in particular, mild TBI and concussion—parallels the growth of public interest in the field. As the international scientific community aligns itself to better diagnose, treat, and manage this injury ( 79 ), which

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Memory Impairments Associated With Mild Traumatic Brain Injury: A Critically Appraised Topic

Karlee Burns, Leah Sanford, Ryan Tierney, and Jane McDevitt

Key Points ▸ Adolescents and young adults with sport-related mild traumatic brain injury (i.e., 9 days to 12 months postinjury) performed worse on memory tests than healthy controls. ▸ There is low-level evidence suggesting structural changes (e.g., cortical thinning) are occurring following sport

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Do Cognitive Behavioral Therapy Techniques Reduce Symptom Duration in Children and Adolescents Who Have Sustained a Mild Traumatic Brain Injury?

Carlie K. Elmer and Tamara C. Valovich McLeod

therapy and its effect on symptoms in children and adolescents with diagnosed concussions. Focused Clinical Question Does CBT reduce concussion symptoms among children and adolescents following mild traumatic brain injury? Search Strategy A comprehensive search of PubMed, CINAHL, MEDLINE, SPORTDiscus

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Applying Physical Activity Motivation Theories to People with Brain Injuries

Simon Driver

The purpose of the paper is to provide specialists with theoretical frameworks that can be used to guide the creation of physical activity interventions as well as facilitating participation for people with traumatic brain injuries. Two frameworks for examining the physical activity motivation of people with brain injuries are presented. The theories include Bandura’s (1986) self-efficacy theory and Harter’s (1987) mediational model of self-worth. The constructs within both theories are explained and then applied to people with brain injuries. Suggestions for practitioners are also provided about how to manipulate the physical activity environment to promote physical activity participation.

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Measuring Exercise Induced Affect in Adults with Brain Injuries

Simon Driver

The aim of the study was to provide evidence for the validity and reliability of the Physical Activity Affect Scale (PAAS; Lox, Jackson, Tuholski, Wasley, & Treasure, 2000) as a measure of exercise induced affect for adults with brain injuries. The PAAS is a 12-item measure of feeling states based on Russell’s (1980) conceptualization of affect. A confirmatory factor analysis was conducted on data from 193 participants with brain injuries who completed the PAAS following a single bout of exercise. Results identified four dimensions of affect (positive affect, negative affect, tranquility, and fatigue). Findings provide evidence for the validity and reliability of the PAAS as a measure of exercise induced affect for adults with brain injuries.

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Development of a Conceptual Model to Predict Physical Activity Participation in Adults with Brain Injuries

Simon Driver

The purpose was to examine psychosocial factors that influence the physical activity behaviors of adults with brain injuries. Two differing models, based on Harter’s model of self-worth, were proposed to examine the relationship between perceived competence, social support, physical self-worth, affect, and motivation. Adults numbering 384 with brain injuries completed a series of questionnaires measuring each psychosocial variable. The structural analysis indicated a nonsignificant chi squared value and good fit indices for model two which included affect as the mediating variable. Findings indicate that affect is critical in shaping the physical activity cognitions and behaviors of adults with brain injuries. Suggestions are made on practical ways to enhance affect and subsequently physical activity participation.

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Acute Subdural Hematoma in a High School Football Player Requiring Emergent Decompressive Craniectomy

Christine C. Center, Samuel J. Wilkins, Ross Mathiasen, and Adam B. Rosen

number of injuries related to football, fatalities resulting from brain injury during football participation have remained consistent. 2 The trend in American football catastrophic head injuries has risen over the past 30 years. 3 Subdural hemorrhages (SDHs) are the leading cause of brain

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Psychometric Properties and Analysis of the Physical Activity Social Influence Scale for Adults with Traumatic Brain Injuries

Simon J. Driver

The study consisted of (a) assessing the validity and reliability of the Social Influence Scale (SIS) for adults with brain injuries and (b) examining the types and sources of social influence and demographic variables that affect participants’ physical activity behaviors. Three confirmatory factor analyses, intraclass correlations, and a repeated measures MANOVA were completed on responses from 402 adults with brain injuries. Results provide evidence of the validity and reliability of the SIS, and post hoc analyses revealed that participants reported receiving different types of social influence from family, friends, and caregivers. Findings have implications for specialists and suggestions are provided on ways to enhance the physical activity participation of adults with brain injuries.

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Intensive Mobility Training as a Means of Late Rehabilitation after Brain Injury

H. Jan Dordel

Individuals with severe physical and psychomotor modifications after a brain injury need measures of motor training beyond the usual physiotherapy. The effects of an intensive mobility training in the phase of late rehabilitation are reported in two case studies. The coordinative and conditional progresses were controlled by the methods of photographic anthropometry, light-track registration, and bicycle ergometry. Improvements were found in posture and dynamic endurance in correlation with the generally improving motor control. Tests of everyday relevant movements revealed qualitative progresses in the sense of increased motor precision and economy.

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Physical Activity Experiences of Individuals Living With a Traumatic Brain Injury: A Qualitative Research Exploration

Megan Self, Simon Driver, Laurel Stevens, and Ann Marie Warren

Traumatic brain injury (TBI) is a significant public health issue due to the incidence, complexity, and cost associated with treatment. The purpose of this study was to determine physical activity (PA) knowledge, attitudes, intentions, and barriers among individuals with a TBI undergoing outpatient rehabilitation. Seventeen participants completed a series of group interviews regarding their PA needs. A qualitative research design was adopted and trustworthiness was established through investigator triangulation of data. A cross-case analysis was completed to identify themes and conceptual patterns. The main themes identified were (a) an inability to differentiate between PA and physical therapy, (b) a limited knowledge of PA health benefits and the relationship to rehabilitation, and (c) an interest in participating in a PA based health promotion program. Future interventions should educate individuals about PA, the associated health benefits, and the role PA plays in the rehabilitation process.