Effects of Aerobic Exercise on Cognition,Cerebral Brain Flow and Mental Health Among Traumatic Brain Injury Patients

Develop and Rehabilitation Effects of the Safety Aerobic Exercise Prescription on Cognition, Depression and Quality of Life in Traumatic Brain Injury Patients- Taking the Cerebral Blood Circulation as a Mediator

The aim of this study is to develop exercise prescription of TBI patients and then to evaluate the effectiveness of programmed aerobic walking exercise to improve cognitive performance, depression relief, motivation, symptom, resilience and quality of life with improvement of CBF. This will be a randomized controlled clinical trial, using a mixed method to explore the feasibility and validity of such a safety exercise prescription. Then, a randomized clinical control trial will be applied in TBI patients to evaluate the effectiveness of programmed aerobic exercise to promote psysical-psycho-social health such as cognitive status, 6 minutes walk test, depression relief, motivation, symptom, resilience and quality of life.

Study Overview

• Status: Recruiting
• Conditions: Cardiology; Psychiatry
• Intervention / Treatment: Device: telehealth-based aerobic walking exercise

Detailed Description

Traumatic Brain Injury (TBI) brings out the major cause of accidental disability. Aerobic exercise can increase the influx of blood circulation improving cognitive performance, such as walking and cycling. Yet the effective exercise prescription improves cerebral blood flow (CBF) on promoting psysical-psycho-social health such as cognitive status, 6 minutes walk test, depression relief, motivation, symptom, resilience and quality of life. PI conducted a retrospective study in TBI patients and results indicated that 93% of patients discharged among 5000 TBI patients in the past decade. However, about 70% TBI outpatients have squeals left by TBI, which not only affect physical activity, cognition, but also cause mental health problems such as depression and also family care burden and huge medical burdens. The preliminary data showed the significant effects of promoting cerebral blood flow (CBF) through aerobic exercise. This study intends to explore the effectiveness of aerobic exercise prescription among patients with TBI on their physical and mental health based on PI's experiences of walking exercise intervention research and their publications.

The aim of this study is to develop exercise prescription of TBI patients and then to evaluate the effectiveness of programmed aerobic exercise to improve psysical-psycho-social health such as cognitive status, 6 minutes walk test, depression relief, motivation, symptom, resilience and quality of life with improvement of CBF. This will be a comprehensive randomized controlled clinical trial using a mixed method to explore the feasibility of such a safety exercise prescription. Then, a randomized clinical control trial will be applied in TBI patients to evaluate the effectiveness of programmed aerobic exercise to promote psysical-psycho-social health such as cognitive status, 6 minutes walk test, depression relief, motivation, symptom, resilience and quality of life.

First, a concurrent parallel design combining qualitative and quantitative mixed methods approach will be conducted to explore the accuracy and appropriateness of the prescription and predictability of the mental health and user's experiences. We plan to recruit 30 TBI patients who will be intervened with moderate to high intensity aerobic exercise. We will collect informations regarding CBF and cardiac force index (CFI) during the progress of aerobic exercise. Moreover, we will evaluate the psysical-psycho-social health such as cognitive status, 6 minutes walk test, depression relief, motivation, symptom, resilience and quality of life. We will examine the sensitivity, specificity and accuracy of the CFI and CBF monitor system, and to explore the experience of adopting aerobic exercise prescription among TBI patients. Depending on the results of the first two years, the safety aerobic exercise prescription with CFI and CBF monitor system will be modified and piloted in the next stage. We plan to recruit at least 120 patients and randomized them into an intervention group (N=60) that received the aerobic exercise prescription and a control group (N=60) that received usual care. Outcome variables will be followed at the pretest, the first, second, third and sixth month after the exercise prescription has been implemented. Intention-to-treat and multiple linear models will be used to analyze the results. We hope to develop the safety aerobic exercise prescription with empirical evidence of promoting mental health for patients with TBI.

• Study Type: Interventional
• Enrollment (Estimated): 120
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Hui-Hsun Chiang, PhD; Phone Number: 18761 02-8792-6692; Email: sheisvivian@gmail.com

Study Locations

• Taiwan
  • Taipei city, Taiwan
    • Recruiting
    • TSGH

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Patients who have been diagnosed with mild traumatic brain injury at the emergency department
2. GCS score of 14-15 at the emergency department or patients with moderate brain injury (GCS score of 8-13
3. Brain injury Patients more than three months after discharge
4. Can communicate in Chinese and Taiwanese
5. Patients who have good audio-visual ability to complete tests and data filling
6. Patients are willing to sign a consent form to participate in the research.
7. Each subject was able to walk on their own, communicate freely and live in Taipei or Greater Taipei.

Exclusion Criteria:

1. Exclude those with severe impairment of cognition, emotions and executive function caused by prefrontal lobe injury
2. Exclude patients with brain injury due to head puncture.
3. Regularly perform moderate-intensity aerobic exercise.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: this study is to develop exercise prescription of TBI patients; The aim of this study is to develop exercise prescription of TBI patients and then to evaluate the effectiveness of programmed aerobic exercise to improve psysical-psycho-social health such as cognitive status, 6 minutes walk test, depression relief, motivation, symptom, resilience and quality of life. This will be a randomized-controlled clinical trial, by using a mixed method to explore the feasibility and validity of such a safety exercise prescription. In the next stage, a randomized clinical control trial will be applied in TBI patients to evaluate the effectiveness of programmed aerobic exercise to promote psysical-psycho-social health such as cognitive status, 6 minutes walk test, depression relief, motivation, symptom, resilience and quality of life.	Device: telehealth-based aerobic walking exercise; The aim of this study is to develop exercise prescription of TBI patients and then to evaluate the effectiveness of programmed aerobic exercise to improve psysical-psycho-social health such as cognitive status, 6 minutes walk test, depression relief, motivation, symptom, resilience and quality of life.; Other Names: walking; aerobic exercise; walking exercise; theoretical-based aerobic exercise
No Intervention: No exercise prescription in TBI patients; Routine Care of TBI Patients

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
cerebral blood flow (CBF)-(T1)	Hemoencephalography (HEG) will be measure by Bioland, the unit is ratio A/B and the brain SPECT	T1_Baseline
cerebral blood flow (CBF)-(T2)	Hemoencephalography (HEG) will be measure by Bioland, the unit is ratio A/Band	T2_1 month later
cerebral blood flow (CBF)-(T3)	Hemoencephalography (HEG) will be measure by Bioland, the unit is ratio A/B	T3_2 months later
cerebral blood flow (CBF)-(T4)	Hemoencephalography (HEG) will be measure by Bioland, the unit is ratio A/B	T4_3 months later
cerebral blood flow (CBF)-(T5)	Hemoencephalography (HEG) will be measure by Bioland, the unit is ratio A/B and the brain SPECT	T5_6 months later
cerebral blood flow (CBF)-(T6)	Hemoencephalography (HEG) will be measure by Bioland, the unit is ratio A/B	T6_12 months later
6 minutes walk test-(T1)	The 6 Minute Walk Test is a sub-maximal exercise test used to assess aerobic capacity and endurance. The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity.The 6MWT can be used in preschool children (2-5 years), children (6-12 years) adults (18-64 years), elderly adults (65+) with a wide range of diagnoses including. The test was initially designed to help in the assessment of patient with cardiopulmonary issues. Gradually, it was introduced in numerous other conditions. It evaluates the functional capacity of the individual and it provides valuable information regarding all the systems during physical activity, including pulmonary and cardiovascular systems, blood circulation, neuromuscular units, body metabolism, and peripheral circulation.	T1-Baseline
6 minutes walk test-(T2)	The 6 Minute Walk Test is a sub-maximal exercise test used to assess aerobic capacity and endurance. The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity.The 6MWT can be used in preschool children (2-5 years), children (6-12 years) adults (18-64 years), elderly adults (65+) with a wide range of diagnoses including. The test was initially designed to help in the assessment of patient with cardiopulmonary issues. Gradually, it was introduced in numerous other conditions. It evaluates the functional capacity of the individual and it provides valuable information regarding all the systems during physical activity, including pulmonary and cardiovascular systems, blood circulation, neuromuscular units, body metabolism, and peripheral circulation.	T2-1 month later
6 minutes walk test-(T3)	The 6 Minute Walk Test is a sub-maximal exercise test used to assess aerobic capacity and endurance. The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity.The 6MWT can be used in preschool children (2-5 years), children (6-12 years) adults (18-64 years), elderly adults (65+) with a wide range of diagnoses including. The test was initially designed to help in the assessment of patient with cardiopulmonary issues. Gradually, it was introduced in numerous other conditions. It evaluates the functional capacity of the individual and it provides valuable information regarding all the systems during physical activity, including pulmonary and cardiovascular systems, blood circulation, neuromuscular units, body metabolism, and peripheral circulation.	T3-2 months later
6 minutes walk test-(T4)	The 6 Minute Walk Test is a sub-maximal exercise test used to assess aerobic capacity and endurance. The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity.The 6MWT can be used in preschool children (2-5 years), children (6-12 years) adults (18-64 years), elderly adults (65+) with a wide range of diagnoses including. The test was initially designed to help in the assessment of patient with cardiopulmonary issues. Gradually, it was introduced in numerous other conditions. It evaluates the functional capacity of the individual and it provides valuable information regarding all the systems during physical activity, including pulmonary and cardiovascular systems, blood circulation, neuromuscular units, body metabolism, and peripheral circulation.	T4-3 months later
6 minutes walk test-(T5)	The 6 Minute Walk Test is a sub-maximal exercise test used to assess aerobic capacity and endurance. The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity.The 6MWT can be used in preschool children (2-5 years), children (6-12 years) adults (18-64 years), elderly adults (65+) with a wide range of diagnoses including. The test was initially designed to help in the assessment of patient with cardiopulmonary issues. Gradually, it was introduced in numerous other conditions. It evaluates the functional capacity of the individual and it provides valuable information regarding all the systems during physical activity, including pulmonary and cardiovascular systems, blood circulation, neuromuscular units, body metabolism, and peripheral circulation.	T5-6 months later
6 minutes walk test-(T6)	The 6 Minute Walk Test is a sub-maximal exercise test used to assess aerobic capacity and endurance. The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity.The 6MWT can be used in preschool children (2-5 years), children (6-12 years) adults (18-64 years), elderly adults (65+) with a wide range of diagnoses including. The test was initially designed to help in the assessment of patient with cardiopulmonary issues. Gradually, it was introduced in numerous other conditions. It evaluates the functional capacity of the individual and it provides valuable information regarding all the systems during physical activity, including pulmonary and cardiovascular systems, blood circulation, neuromuscular units, body metabolism, and peripheral circulation.	T6-12 months later
Cardio force index (CFI)-(T1)	CFI was measured by Bioharness device. The ratio is HR/peak activity. CFI is the index of cardiac force, correlated to VO2 max and can predict the physiological status of physical activity. The heart rate, respiratory rate, distance of walking/ exercise and angular acceleration are also be measured by Bioharness device in the same time to calculate the CFI.	T1-Baseline
Cardio force index (CFI)-(T2)	CFI was measured by Bioharness device. The ratio is HR/peak activity. CFI is the index of cardiac force, correlated to VO2 max and can predict the physiological status of physical activity. The heart rate, respiratory rate, distance of walking/ exercise and angular acceleration are also be measured by Bioharness device in the same time to calculate the CFI.	T2-1 month later
Cardio force index (CFI)-(T3)	CFI was measured by Bioharness device. The ratio is HR/peak activity. CFI is the index of cardiac force, correlated to VO2 max and can predict the physiological status of physical activity. The heart rate, respiratory rate, distance of walking/ exercise and angular acceleration are also be measured by Bioharness device in the same time to calculate the CFI.	T3-2 month later
Cardio force index (CFI)-(T4)	CFI was measured by Bioharness device. The ratio is HR/peak activity. CFI is the index of cardiac force, correlated to VO2 max and can predict the physiological status of physical activity. The heart rate, respiratory rate, distance of walking/ exercise and angular acceleration are also be measured by Bioharness device in the same time to calculate the CFI.	T4-3 months later
Cardio force index (CFI)-(T5)	CFI was measured by Bioharness device. The ratio is HR/peak activity. CFI is the index of cardiac force, correlated to VO2 max and can predict the physiological status of physical activity. The heart rate, respiratory rate, distance of walking/ exercise and angular acceleration are also be measured by Bioharness device in the same time to calculate the CFI.	T5-6 months later
Cardio force index (CFI)-(T6)	CFI was measured by Bioharness device. The ratio is HR/peak activity. CFI is the index of cardiac force, correlated to VO2 max and can predict the physiological status of physical activity. The heart rate, respiratory rate, distance of walking/ exercise and angular acceleration are also be measured by Bioharness device in the same time to calculate the CFI.	T6-12 months later

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cognitive function-(T1)	Cognitive function will be measured by the Mini-Mental State Exam (MMSE )instrument. The Mini-Mental State Exam (MMSE) is a widely used test of cognitive function ... school (but not a graduate of), a score on the MMSE of 24 or below means cognitive impairment.	T1-Baseline
Cognitive function-(T2)	Cognitive function will be measured by the Mini-Mental State Exam (MMSE )instrument. The Mini-Mental State Exam (MMSE) is a widely used test of cognitive function ... school (but not a graduate of), a score on the MMSE of 24 or below means cognitive impairment.	T2-1month later
Cognitive function-(T3)	Cognitive function will be measured by the Mini-Mental State Exam (MMSE )instrument. The Mini-Mental State Exam (MMSE) is a widely used test of cognitive function ... school (but not a graduate of), a score on the MMSE of 24 or below means cognitive impairment.	T3-2month later
Cognitive function-(T4)	Cognitive function will be measured by the Mini-Mental State Exam (MMSE )instrument. The Mini-Mental State Exam (MMSE) is a widely used test of cognitive function ... school (but not a graduate of), a score on the MMSE of 24 or below means cognitive impairment.	T4-3month later
Cognitive function-(T5)	Cognitive function will be measured by the Mini-Mental State Exam (MMSE )instrument. The Mini-Mental State Exam (MMSE) is a widely used test of cognitive function ... school (but not a graduate of), a score on the MMSE of 24 or below means cognitive impairment.	T5-6months later
Cognitive function-(T6)	Cognitive function will be measured by the Mini-Mental State Exam (MMSE )instrument. The Mini-Mental State Exam (MMSE) is a widely used test of cognitive function ... school (but not a graduate of), a score on the MMSE of 24 or below means cognitive impairment.	T6-12months later
Brain single photon emission computed tomography (SPECT)-(T1)	brain Single Photon Emission Computed Tomography (SPECT) imaging has developed a substantial, evidence-based foundation and is now recommended by professional societies for numerous indications relevant to psychiatric practice.	T1_Baseline
Brain single photon emission computed tomography (SPECT)-(T4)	brain Single Photon Emission Computed Tomography (SPECT) imaging has developed a substantial, evidence-based foundation and is now recommended by professional societies for numerous indications relevant to psychiatric practice.	T4_6 months later

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
depression status-(T1)	Depression will be measured by Beck depression index (BDI). The BDI scale is a brief self-report scale designed to measure self-reported symptoms associated with depression experienced in the past. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. A score is assigned by totaling all items (after reversing the positive mood items]. The possible range for the 21-item scale is 0 to 63, and a cut off score of 16 or higher indicates the presence of significant depressive symptoms.	T1-Baseline
depression status-(T2)	Depression will be measured by Beck depression index (BDI). The BDI scale is a brief self-report scale designed to measure self-reported symptoms associated with depression experienced in the past. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. A score is assigned by totaling all items (after reversing the positive mood items]. The possible range for the 21-item scale is 0 to 63, and a cut off score of 16 or higher indicates the presence of significant depressive symptoms.	T2-1 month later
depression status-(T3)	Depression will be measured by Beck depression index (BDI). The BDI scale is a brief self-report scale designed to measure self-reported symptoms associated with depression experienced in the past. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. A score is assigned by totaling all items (after reversing the positive mood items]. The possible range for the 21-item scale is 0 to 63, and a cut off score of 16 or higher indicates the presence of significant depressive symptoms.	T3-2 months later
depression status-(T4)	Depression will be measured by Beck depression index (BDI). The BDI scale is a brief self-report scale designed to measure self-reported symptoms associated with depression experienced in the past. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. A score is assigned by totaling all items (after reversing the positive mood items]. The possible range for the 21-item scale is 0 to 63, and a cut off score of 16 or higher indicates the presence of significant depressive symptoms.	T4-3 months later
depression status-(T5)	Depression will be measured by Beck depression index (BDI). The BDI scale is a brief self-report scale designed to measure self-reported symptoms associated with depression experienced in the past. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. A score is assigned by totaling all items (after reversing the positive mood items]. The possible range for the 21-item scale is 0 to 63, and a cut off score of 16 or higher indicates the presence of significant depressive symptoms.	T5-6 months later
depression status-(T6)	Depression will be measured by Beck depression index (BDI). The BDI scale is a brief self-report scale designed to measure self-reported symptoms associated with depression experienced in the past. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. A score is assigned by totaling all items (after reversing the positive mood items]. The possible range for the 21-item scale is 0 to 63, and a cut off score of 16 or higher indicates the presence of significant depressive symptoms.	T6-12 months later
Quality of life-(T1): WHOQOL-BREF	Quality of life will be measured by World Health organization quality of life (WHOQOL) instrument. The WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health (7 items), psychological health (6 items), social relationships (3 items), and environmental health (8 items); it also contains QOL and general health items.The WHOQOL-BREF is a shorter version of the original instrument that may be more convenient for use in large research studies or clinical trials.	T1-Baseline
Quality of life-(T2): WHOQOL-BREF	Quality of life will be measured by World Health organization quality of life (WHOQOL) instrument. The WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health (7 items), psychological health (6 items), social relationships (3 items), and environmental health (8 items); it also contains QOL and general health items.The WHOQOL-BREF is a shorter version of the original instrument that may be more convenient for use in large research studies or clinical trials.	T2-1 month later
Quality of life-(T3): WHOQOL-BREF	Quality of life will be measured by World Health organization quality of life (WHOQOL) instrument. The WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health (7 items), psychological health (6 items), social relationships (3 items), and environmental health (8 items); it also contains QOL and general health items.The WHOQOL-BREF is a shorter version of the original instrument that may be more convenient for use in large research studies or clinical trials.	T3-2 month later
Quality of life-(T4): WHOQOL-BREF	Quality of life will be measured by World Health organization quality of life (WHOQOL) instrument. The WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health (7 items), psychological health (6 items), social relationships (3 items), and environmental health (8 items); it also contains QOL and general health items.The WHOQOL-BREF is a shorter version of the original instrument that may be more convenient for use in large research studies or clinical trials.	T4-3 months later
Quality of life-(T5): WHOQOL-BREF	Quality of life will be measured by World Health organization quality of life (WHOQOL) instrument. The WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health (7 items), psychological health (6 items), social relationships (3 items), and environmental health (8 items); it also contains QOL and general health items.The WHOQOL-BREF is a shorter version of the original instrument that may be more convenient for use in large research studies or clinical trials.	T5- 6 months later
Quality of life-(T6): WHOQOL-BREF	Quality of life will be measured by World Health organization quality of life (WHOQOL) instrument. The WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health (7 items), psychological health (6 items), social relationships (3 items), and environmental health (8 items); it also contains QOL and general health items.The WHOQOL-BREF is a shorter version of the original instrument that may be more convenient for use in large research studies or clinical trials.	T6- 12 months later
resilience status-(T1)	Resilience will be measured by Resilience scale for adult scale. The Resilience Scale for Adults (RSA) (Friborg et al., 2003) is a 37-item scale that measures resilience as healthy adaptation and personal competence during exposure to significant adversity, trauma, or stress.	T1-Baseline
resilience status-(T2)	Resilience will be measured by Resilience scale for adult scale. The Resilience Scale for Adults (RSA) (Friborg et al., 2003) is a 37-item scale that measures resilience as healthy adaptation and personal competence during exposure to significant adversity, trauma, or stress.	T2-1 month later
resilience status-(T3)	Resilience will be measured by Resilience scale for adult scale. The Resilience Scale for Adults (RSA) (Friborg et al., 2003) is a 37-item scale that measures resilience as healthy adaptation and personal competence during exposure to significant adversity, trauma, or stress.	T3-2 month later
resilience status-(T4)	Resilience will be measured by Resilience scale for adult scale. The Resilience Scale for Adults (RSA) (Friborg et al., 2003) is a 37-item scale that measures resilience as healthy adaptation and personal competence during exposure to significant adversity, trauma, or stress.	T4-3 months later
resilience status-(T5)	Resilience will be measured by Resilience scale for adult scale. The Resilience Scale for Adults (RSA) (Friborg et al., 2003) is a 37-item scale that measures resilience as healthy adaptation and personal competence during exposure to significant adversity, trauma, or stress.	T5-6 months later
resilience status-(T6)	Resilience will be measured by Resilience scale for adult scale. The Resilience Scale for Adults (RSA) (Friborg et al., 2003) is a 37-item scale that measures resilience as healthy adaptation and personal competence during exposure to significant adversity, trauma, or stress.	T6-12 months later
Post-concussion symptom-(T1)	post-concussion will be measured by the Rivermead post-concussion symptom scale.	T1-Baseline
Post-concussion symptom-(T2)	post-concussion will be measured by the Rivermead post-concussion symptom scale.	T2-1 month later
Post-concussion symptom-(T3)	post-concussion will be measured by the Rivermead post-concussion symptom scale.	T3-2 months later
Post-concussion symptom-(T4)	post-concussion will be measured by the Rivermead post-concussion symptom scale.	T4-3 months later
Post-concussion symptom-(T5)	post-concussion will be measured by the Rivermead post-concussion symptom scale.	T5-6 months later
Post-concussion symptom-(T6)	post-concussion will be measured by the Rivermead post-concussion symptom scale.	T6-12 months later
Self-efficacy-(T1)	Self-efficacy will be measured by the self-efficacy scale.	T1- Baseline
Self-efficacy-(T2)	Self-efficacy will be measured by the self-efficacy scale.	T2- 1 month later
Self-efficacy-(T3)	Self-efficacy will be measured by the self-efficacy scale.	T3- 2 months later
Self-efficacy-(T4)	Self-efficacy will be measured by the self-efficacy scale.	T4- 3 months later
Self-efficacy-(T5)	Self-efficacy will be measured by the self-efficacy scale.	T5- 6 months later
Self-efficacy-(T6)	Self-efficacy will be measured by the self-efficacy scale.	T6- 12 months later
Sleep quality-(T1)	Sleep quality will be measured by the Pittsburgh sleep quality scale and the Garmin vivosmart sleep records and its physiological recording.	T1- Baseline
Sleep quality-(T2)	Sleep quality will be measured by the Pittsburgh sleep quality scale and the Garmin vivosmart sleep records and its physiological recording.	T2- 1 month later
Sleep quality-(T3)	Sleep quality will be measured by the Pittsburgh sleep quality scale and the Garmin vivosmart sleep records and its physiological recording.	T3- 2 months later
Sleep quality-(T4)	Sleep quality will be measured by the Pittsburgh sleep quality scale and the Garmin vivosmart sleep records and its physiological recording.	T4- 3 months later
Sleep quality-(T5)	Sleep quality will be measured by the Pittsburgh sleep quality scale and the Garmin vivosmart sleep records and its physiological recording.	T5- 6 months later
Sleep quality-(T6)	Sleep quality will be measured by the Pittsburgh sleep quality scale and the Garmin vivosmart sleep records and its physiological recording.	T6- 12 months later
Sport motivation Scale-(T1)	Sport motivation will be measure by the Sport Motivation Scale II (SMS-II)and exercise motivation interview. The 18-item SMS-II consists of six subscalesmeasuring amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic motivation. Each subscale has three items. Participants were asked to respond to all the items on a 7-point Likert scale ranging from 1 (not true at all) to 7 (very true).	T1- baseline
Sport motivation Scale-(T2)	Sport motivation will be measure by the Sport Motivation Scale II (SMS-II)and exercise motivation interview. The 18-item SMS-II consists of six subscalesmeasuring amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic motivation. Each subscale has three items. Participants were asked to respond to all the items on a 7-point Likert scale ranging from 1 (not true at all) to 7 (very true).	T2- 1 month later
Sport motivation Scale-(T3)	Sport motivation will be measure by the Sport Motivation Scale II (SMS-II)and exercise motivation interview. The 18-item SMS-II consists of six subscalesmeasuring amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic motivation. Each subscale has three items. Participants were asked to respond to all the items on a 7-point Likert scale ranging from 1 (not true at all) to 7 (very true).	T3- 2 month later
Sport motivation Scale-(T4)	Sport motivation will be measure by the Sport Motivation Scale II (SMS-II)and exercise motivation interview. The 18-item SMS-II consists of six subscalesmeasuring amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic motivation. Each subscale has three items. Participants were asked to respond to all the items on a 7-point Likert scale ranging from 1 (not true at all) to 7 (very true).	T4- 3 month later
Sport motivation Scale-(T5)	Sport motivation will be measure by the Sport Motivation Scale II (SMS-II)and exercise motivation interview. The 18-item SMS-II consists of six subscalesmeasuring amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic motivation. Each subscale has three items. Participants were asked to respond to all the items on a 7-point Likert scale ranging from 1 (not true at all) to 7 (very true).	T5- 6 month later
Sport motivation Scale-(T6)	Sport motivation will be measure by the Sport Motivation Scale II (SMS-II)and exercise motivation interview. The 18-item SMS-II consists of six subscalesmeasuring amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic motivation. Each subscale has three items. Participants were asked to respond to all the items on a 7-point Likert scale ranging from 1 (not true at all) to 7 (very true).	T6- 12 month later

Collaborators and Investigators

• Sponsor: National Defense Medical Center, Taiwan
• Collaborators: Ministry of Science and Technology, Taiwan
• Investigators: Principal Investigator: Hui-Hsun Chiang, PhD, National Defense Medical Center

Publications and helpful links

General Publications

• Vanderbeken I, Kerckhofs E. A systematic review of the effect of physical exercise on cognition in stroke and traumatic brain injury patients. NeuroRehabilitation. 2017;40(1):33-48. doi: 10.3233/NRE-161388.
• Churchill JD, Galvez R, Colcombe S, Swain RA, Kramer AF, Greenough WT. Exercise, experience and the aging brain. Neurobiol Aging. 2002 Sep-Oct;23(5):941-55. doi: 10.1016/s0197-4580(02)00028-3.
• Hassett LM, Moseley AM, Tate R, Harmer AR. Fitness training for cardiorespiratory conditioning after traumatic brain injury. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD006123. doi: 10.1002/14651858.CD006123.pub2.
• Snyder HR, Kaiser RH, Warren SL, Heller W. Obsessive-compulsive disorder is associated with broad impairments in executive function: A meta-analysis. Clin Psychol Sci. 2015 Mar;3(2):301-330. doi: 10.1177/2167702614534210.
• Taylor JM, Montgomery MH, Gregory EJ, Berman NE. Exercise preconditioning improves traumatic brain injury outcomes. Brain Res. 2015 Oct 5;1622:414-29. doi: 10.1016/j.brainres.2015.07.009. Epub 2015 Jul 9.
• Devine JM, Wong B, Gervino E, Pascual-Leone A, Alexander MP. Independent, Community-Based Aerobic Exercise Training for People With Moderate-to-Severe Traumatic Brain Injury. Arch Phys Med Rehabil. 2016 Aug;97(8):1392-7. doi: 10.1016/j.apmr.2016.04.015. Epub 2016 May 20.

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2020
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): August 31, 2026

Study Registration Dates

• First Submitted: January 20, 2020
• First Submitted That Met QC Criteria: January 27, 2020
• First Posted (Actual): January 28, 2020

Study Record Updates

• Last Update Posted (Estimated): November 14, 2023
• Last Update Submitted That Met QC Criteria: November 10, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: physical health care; Activity of Daily Living,ADL
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Wounds and Injuries; Craniocerebral Trauma; Trauma, Nervous System; Brain Injuries; Brain Injuries, Traumatic
• Other Study ID Numbers: 30988

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No