Jennifer Rowland, Ph.D.

Several studies have reported that people with TBI are more likely to be sedentary (Mossberg et al., 2007), have greater health problems (Bateman et al., 2001; Dault & Dugas, 2002; Kersel et al., 2001), and experience substantially more barriers to physical activity participation compared to the general population (Rimmer et al, 2004). Deconditioning exacerbates the physical and cognitive disabilities that persons with TBI experience, and persons with moderate to severe TBI may have a low tolerance for physical activity and become easily fatigued (Bhambhani, Rowland, Farab, 2003). Unfortunately, as physical activities are eliminated from their daily routine, the ability to perform equal or greater amounts of activity declines even further for this population (Macko et al, 2005, Rimmer & Wang, 2005). As a result of these limitations, people with TBI often find it difficult to function within their communities (Corr & Bayer, 1992). In addition to the health consequences of inactivity, persons experiencing fatigue and physical limitations are less likely to engage in social interaction or pursue meaningful leisure activities (Petajan et al, 1996).

Mental health problems, including depression, and psychosocial issues, such as decreased self-esteem and social networking, can also prove to be considerable obstacles for persons with TBI (Driver et al., 2006). Social isolation exacerbates such problems, and the challenges of community re-entry, or community integration, have been reported in the literature since the 1980s (Minnes et al., 2001). Even those individuals with TBI who are living in the community are reported to be marginalized, as their needs have not been diagnosed, nor are they fully involved in community activity (Minnes et al., 2001). Such lack of community integration prevents them from accessing health promotion resources, whether these include involvement in community fitness centers, or assuming other self-management behaviors, including medication management and stress management. NCHPAD offers the following resources for health promotion and physical activity related to persons with TBI:

• Acquired Brain Injury at http://www.ncpad.org/98/723/Acquired~Brain~Injury
• Combating Fatigue: Diet, Exercise, Sleep at http://www.ncpad.org/82/606/Combating~Fatigue~~Diet~~Exercise~~Sleep
• Getting Past Fatigue at http://www.ncpad.org/169/1298/Getting~Past~Fatigue
• Health Promotion for People with Disabilities: The Need for a Transitional Model in Service Delivery at http://www.ncpad.org/102/765/Health~Promotion~for~People~with~Disabilities~~The~Need~for~a~ Transitional~Model~in~Service~Delivery
• Searchable Organizations Database including information such as:
  • Brain Injury Association of America at http://www.ncpad.org/16/Organizations/2056
  • Brain Injury Resource Foundation at http://www.ncpad.org/16/Organizations/2708
• Searchable Programs Database containing information on programs for people with disabilities including TBI at http://www.ncpad.org/directories/15/Programs.

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