Effect of fatigue on standing balance and cognition in mild Traumatic Brain Injury

Problem Statement: Annually, 2 million Traumatic Brain Injuries (TBI) are recorded and 70-90% are considered mild Traumatic Brain Injuries (mTBI). Fatigue is one of the most frequently reported symptoms in those with mTBI. This study will evaluate the effects of a moderately fatiguing exercise on standing balance and cognition in individuals who have sustained a mTBI. The results of this project will help us to design a better rehabilitation intervention for individuals with mTBI. Methods: We will recruit 10 individuals with mTBI for one visit that will last 2.5 hours. Standing balance and cognition will be assessed before and after a moderately fatiguing exercise. A standardized force platform will be utilized for quantifying various parameters of postural sway during four conditions: bipedal-eyes open (BEO), bipedal-eyes closed (BEC), staggered-eyes open (SEO) and staggered-eyes closed (SEC). Cognition will be assessed using NIH Toolbox- Cognitive battery. We will primarily measure processing speed, attention, memory and executive function domains of cognitive function. Results: Thus far, we have finished data collection and initial analysis of 3 participants with mTBI. Additional 7 participants are currently being enrolled for the study. Our preliminary analysis reveals that postural sway area and velocity decreased after fatiguing exercise in all conditions except SEO. Cognitive measures for all domains showed improvement after the fatiguing exercise with least improvement in episodic memory. Conclusion: Our initial results indicate potential beneficial effects of moderately fatiguing exercise in individuals with mTBI. Decreased postural sway would imply an increase in postural stability during Activities of Daily Living (ADLs). Further improved cognitive function can explain the need of moderate exercise in patients who have cognitive deficits. Future research should be done to determine the full spectrum of fatigability in mTBI