Hale J1, Bezner J1, Hurley G1, Turk M1, Pazary N1, Arceneaux M1
1Texas State University, Department of Physical Therapy, Round Rock, United States
Background: Acquired Brain Injury (ABI) is a chronic condition that leads to physical, cognitive, emotional, and social limitations across the lifespan. Wellness is the sense that one is living in a manner that permits the experience of consistent, balanced growth in the physical, spiritual, emotional, intellectual, social, and psychological dimensions of human existence. The long-term negative impact of brain injury makes this population especially vulnerable to poor wellness, and little is known about the influences on health and wellness.
Purpose: The primary aim was to measure the health and wellness of residents with ABI to inform programming at a residential community. The secondary aim was to investigate the relationships among variables to discover which factors have the greatest influence on health and wellness in this population. Armed with this information, physiotherapists may be able to enhance the quality of life of people living with ABI and potentially engage in secondary prevention.
Methods: Wellness was assessed across all six domains using a series of performance based outcome measures and self-report questionnaires. Participants included seven residents (male: N=6, female: N=1) ranging in age from 40-67 years (mean = 55.4 years). IRB approval was received and the residential facility and all participants provided informed consent. Self-report measures included: Patient Specific Functional Scale (PSFS), Quality of Life After Brain Injury (QOLIBRI), Multidimensional Assessment of Fatigue (MAF), and Perceived Health Questionnaire 9 (PHQ-9). Physical performance measures included: VO2 maximum testing, 5-Times Sit to Stand (5XSTS), fall-risk assessment with the Berg Balance Scale (BBS) or Functional Gait Analysis (FGA), 6-Minute Walk Test (6MWT), 10-Meter Walk Test (10MWT), and Selective Functional Movement Assessment (SFMA). Data were summarized using descriptive statistics and Pearson's correlation coefficients were calculated. Results were considered significant for a P-value of less than 0.05.
Results: Across all seven participants, the mean walking endurance (6MWT mean = 281 meters), gait speed (10MWT mean = 0.69 m/s), balance (BBS mean = 18, FGA mean = 18), functional strength (5XSTS mean = 19.4 seconds), and aerobic capacity (VO2 maximum mean = 16.25 ml/kg/min) were low compared to age matched normal values and established cut-off scores. Mean survey scores indicated mild depression (PHQ-9 = 7.23), a large reduction in quality of life (QOLIBRI = 63.09), and increased levels of fatigue (MAF = 23.48) comparable to the average population living with disability. Strong and significant negative correlations were found between the level of fatigue and physical performance measures. Specifically, high levels of fatigue (MAF) corresponded with a decrease in gait speed (r = - 0.910, p = 0.032), walking endurance (r = - 0.951, p = 0.013), VO2 max (r = - 0.986, p = 0.014), and balance as measured by the BBS (r = - 0.997, p = 0.049).
Conclusion(s): Based on the significant association identified between fatigue and measures of physical performance, physical therapists should regularly assess fatigue in individuals with ABI. Further research should investigate the relationship between fatigue and wellness in a larger sample size.
Implications: Fatigue may negatively impact health and wellness in patients with chronic ABI, warranting further exploration.
Keywords: Wellness, Brain Injury, Health promotion
Funding acknowledgements: No external funding source to acknowledge
Purpose: The primary aim was to measure the health and wellness of residents with ABI to inform programming at a residential community. The secondary aim was to investigate the relationships among variables to discover which factors have the greatest influence on health and wellness in this population. Armed with this information, physiotherapists may be able to enhance the quality of life of people living with ABI and potentially engage in secondary prevention.
Methods: Wellness was assessed across all six domains using a series of performance based outcome measures and self-report questionnaires. Participants included seven residents (male: N=6, female: N=1) ranging in age from 40-67 years (mean = 55.4 years). IRB approval was received and the residential facility and all participants provided informed consent. Self-report measures included: Patient Specific Functional Scale (PSFS), Quality of Life After Brain Injury (QOLIBRI), Multidimensional Assessment of Fatigue (MAF), and Perceived Health Questionnaire 9 (PHQ-9). Physical performance measures included: VO2 maximum testing, 5-Times Sit to Stand (5XSTS), fall-risk assessment with the Berg Balance Scale (BBS) or Functional Gait Analysis (FGA), 6-Minute Walk Test (6MWT), 10-Meter Walk Test (10MWT), and Selective Functional Movement Assessment (SFMA). Data were summarized using descriptive statistics and Pearson's correlation coefficients were calculated. Results were considered significant for a P-value of less than 0.05.
Results: Across all seven participants, the mean walking endurance (6MWT mean = 281 meters), gait speed (10MWT mean = 0.69 m/s), balance (BBS mean = 18, FGA mean = 18), functional strength (5XSTS mean = 19.4 seconds), and aerobic capacity (VO2 maximum mean = 16.25 ml/kg/min) were low compared to age matched normal values and established cut-off scores. Mean survey scores indicated mild depression (PHQ-9 = 7.23), a large reduction in quality of life (QOLIBRI = 63.09), and increased levels of fatigue (MAF = 23.48) comparable to the average population living with disability. Strong and significant negative correlations were found between the level of fatigue and physical performance measures. Specifically, high levels of fatigue (MAF) corresponded with a decrease in gait speed (r = - 0.910, p = 0.032), walking endurance (r = - 0.951, p = 0.013), VO2 max (r = - 0.986, p = 0.014), and balance as measured by the BBS (r = - 0.997, p = 0.049).
Conclusion(s): Based on the significant association identified between fatigue and measures of physical performance, physical therapists should regularly assess fatigue in individuals with ABI. Further research should investigate the relationship between fatigue and wellness in a larger sample size.
Implications: Fatigue may negatively impact health and wellness in patients with chronic ABI, warranting further exploration.
Keywords: Wellness, Brain Injury, Health promotion
Funding acknowledgements: No external funding source to acknowledge
Topic: Health promotion & wellbeing/healthy ageing; Neurology; Cardiorespiratory
Ethics approval required: Yes
Institution: Texas State University
Ethics committee: Texas State University Institutional Review Board
Ethics number: 2017802
All authors, affiliations and abstracts have been published as submitted.
