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Aerobic Exercise and Cognitive Training Effects on Postconcussive Symptomology

Not Applicable
Completed
Conditions
MTBI - Mild Traumatic Brain Injury
Acquired Brain Injury
Closed Head Injury
Post-Concussion Syndrome
Head Injury
Post-Traumatic Headache
Post-Concussive Syndrome, Chronic
Interventions
Behavioral: Exercise+CT
Behavioral: Exercise only
Registration Number
NCT03674398
Lead Sponsor
University of Illinois at Urbana-Champaign
Brief Summary

The purpose of this study is to compare a 4-week, moderately intensive, lab and home-based aerobic exercise program versus exercise plus cognitive training. Participants will include individuals who experience lingering symptoms of a head injury or concussion.

Detailed Description

Eligible participants will engage in 30 minute bouts of aerobic exercise three times per week followed by a 20-minute post-exercise activity. Randomization will place participants into one of three groups: (1) aerobic exercise + cognitive training, (2) aerobic exercise + videos, or (3) waitlist control. Post-exercise activities will be delivered via participants' smartphone device by downloading the appropriate cognitive training platform or online video link.

Baseline and post-intervention assessments will consist of symptom reporting, cognitive measures, and psychosocial questionnaires. Physiological measures including heart rate and blood pressure will be assessed at baseline and at follow-up as well as during each in-lab exercise session. The wait-list control group is asked to complete all baseline and follow-up assessments and resume normal activity during the four weeks. The first week of exercise will take place in a lab-based environment, while weeks 2-4 will take place outside of the lab (participants must have access to exercise equipment at home or local fitness facility).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
34
Inclusion Criteria
  • Must have history of at least one concussion (onset was at age 18 or later)
  • Ability to exercise at moderate to vigorous activity levels (defined as 50%-75% of the adjusted age-predicted maximum heart rate)
  • Experiencing persistent symptoms (persistent defined as, most days per week for at least 2 weeks since sustaining injury) resulting from concussion or head injury
  • Access to a smartphone and willingness to allow research staff to install application (and space to allow for installation)
  • Access to a treadmill to complete exercise outside of lab environment
  • Willingness to provide proof of concussion or head injury medical diagnosis
  • Willingness to provide contact information of individual to confirm persistent symptoms if medical diagnosis is unavailable
  • Willingness to be randomized into one of three groups
Exclusion Criteria
  • No history of concussion, head injury, or mild traumatic brain injury
  • Experiencing less than 3 persistent symptoms (persistent defined as, most days per week for at least 2 weeks since sustaining injury)
  • No access to a smartphone
  • No access to a treadmill
  • Too active (as defined by regular exercise most days per week for 30+ minutes over the past 3 months)
  • Unable or unwilling to comply to lab and home-based exercise prescription
  • Unable or unwilling to commit to full length of program
  • Incapable of performing moderately intensive aerobic exercise OR sustaining attention to screen for 20 minutes
  • Unwilling to be randomized to one of 3 groups
  • Unable to commute to and from UIUC campus
  • Already involved in regular weekly physical activity or cognitive training program
  • Had previously diagnosed mental health condition (e.g., Major Depressive Disorder, Generalized Anxiety Disorder)
  • Current involvement in litigation specific to injury

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Exercise+CTExercise+CTAerobic exercise for 30 minutes and smart-phone delivered cognitive training application for 20 minutes, 3 times per week for 4 weeks
Exercise onlyExercise onlyAerobic exercise for 30 minutes and smart-phone delivered videos for 20 minutes, 3 times per week for 4 weeks
Primary Outcome Measures
NameTimeMethod
The Rivermead Post Concussion Symptoms QuestionnaireAssessed at baseline and at 1-month follow-up

Self reported symptoms following a head injury. Each of the 16 symptom items (e.g., sleep disturbance) is scored 0-4 (0=not experienced at all; 1=no more of a problem; 2=a mild problem; 3=a moderate problem; 4=a severe problem), yielding a total between 0 and 64. We are targeting change in total symptoms but because of the problems with "change scores" our operational definition of successful change in the primary outcome will be the time 2 total score (1-month follow-up) regressed on group while statistically adjusting for baseline score.

Secondary Outcome Measures
NameTimeMethod
NIH Toolbox Cognition Battery - Working MemoryAssessed at baseline and at 1-month follow-up

List Sorting Working Memory. Participant recalls and sequences different visually and orally presented stimuli. Pictures of different foods and animals are displayed (maximum of 7 at one time) with both an accompanying audio recording and written text that name the item. Participants are asked to say the items back to the examiner in size order from smallest to largest. This test produces a standardized memory accuracy score.

NIH Toolbox Cognition Battery - AttentionAssessed at baseline and at 1-month follow-up

Flanker Inhibitory Control and Attention. Participant focuses on a given stimulus while inhibiting attention to stimuli flanking it. Participants see a row of 5 arrows and choose the button that matches the direction the middle arrow is pointing. This test contains 20 items yielding a standardized accuracy and processing speed score.

Trial Locations

Locations (1)

University of Illinois at Urbana-Champaign

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Urbana, Illinois, United States

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