Anxiety following mild traumatic brain injury

Purpose/Objective: The goals of the present study were (1) to document the prevalence of anxiety-related disorders and anxiety symptoms at 4, 8, and 12 months post-injury in individuals with mild traumatic brain injury (mTBI) while considering pre-injury history of anxiety disorders and (2) to verify whether the presence of anxiety in the first months following mTBI was associated with more symptoms present one year after the injury. Research Method/Design: One hundred and twenty participants hospitalized after an accident and having sustained mTBI were assessed at 4, 8, and 12 months post-accident with the Mini-International Neuropsychiatric Interview, the Hospital Anxiety and Depression Scale and questionnaires assessing fatigue, irritability, perceived stress, cognitive difficulties, depression, insomnia, and pain. Results: At 4 months, 23.8% of participants presented with at least one anxiety-related disorder compared to 15.2% at 8 months and 11.2% at 12 months. Overall, 32.5% presented with at least one anxiety disorder over the first 12 months post-mTBI. Participants with a history of anxiety (20.5%) were significantly more anxious following their accident. Individuals who were anxious 4 months after the accident presented with more symptoms in different areas 12 months post-injury compared to non-anxious individuals. Conclusions/Implications: The present results highlight that anxiety should be evaluated and managed carefully as it appears to be a key factor in the persistence of other mTBI-related symptom

Impacts of Remote Physical Exercises on Functional Status and Mobility among Community-Dwelling Pre-Disabled Seniors during the Covid-19 Lockdown

peer reviewedObjectives: To assess whether remote physical exercise interventions helped maintain function in daily life, level of physical activities, basic mobility and frailty status in pre-disabled seniors during the first Covid-19 lockdown. Design: This is an interventional study conducted from May 2020 to May 2021. Setting: Community-dwelling older adults in 2 Canadian cities. Participants: 84 pre-disabled seniors. Intervention: 12-week physical exercise programs (1 hour/ 3 times/ week) in kinesiologist-guided groups using Zoom or phone-supervised individual booklet-based home-program (n=44) vs. Control (usual life habits; n=40). Measurements: Functional status in daily activities (OARS scale); Daily level of aerobic (TAPA-1) and strengthening/flexibility (TAPA-2) physical activities; Basic mobility abilities (SPPB: balance, lower limbs strength, walking speed; Timed Up-and-Go) and Frailty (SOF index) were assessed at baseline and at 3, 6, 9 and 12-month follow-ups. Results: The participants’ mean age was 78.5 ± 7.2 and 76.5 % were women. There was a group * time effect for the OARS scale (p=0.02), the TAPA-1 (p=0.06) and the TAPA-2 (p=0.007) scores. For these outcomes, scores significantly improved during the first 3 months of follow-up and then stabilised in the intervention group whereas they remained constant in the control group over time. There was an overall time effect for the SPPB (p=0.004), the 4-m walking speed (p=0.02) and for the SOF index (p=0.004), with no between-group differences. Finally, no effect was observed for the TUG. Conclusion: Remote home-based physical exercise interventions and monitoring during the first Covid-19 lockdown seemed to have helped maintain seniors’ level of physical activities without impacting on basic mobility abilities. Further studies are needed to identify parameters of remote exercise programs that can improve daily function and mobility in this population

Life habits performance of individuals with brain injury in different living environments

Background: Little is known about variations in social participation among individuals with traumatic brain injury (TBI) living in different environments. Objective: To examine the social participation of individuals with moderate-to-severe TBI across various living arrangements. Methods: One hundred and thirty-six individuals with moderate-to-severe TBI, living either in natural settings (e.g. home), intermediate settings (e.g. group homes or foster families) or structured settings (e.g. nursing home or long-term care facilities) and requiring daily assistance, were interviewed using the LIFE-H tool, which measures the level of difficulty and the assistance required to carry out life habits and resulting social participation. Participation in six categories of life habits pertaining to Activities of Daily Living and five categories pertaining to Social Roles were examined. Results: The level of difficulty and the assistance required to carry out the life habits and the overall level of social participation were associated with living arrangements. Participation scores in Activities of Daily Living varied across living arrangements while Social Roles scores did not. Conclusion: Living arrangements (such as intermediate settings) may better support social participation in individuals with TBI. There is a need to further study the issue of living arrangements as they seem to facilitate the performance of life habits, which impacts the social participation of individuals with TBI