The Benefits of Exercise After TBI

Some days the idea of going for a run or heading out to the gym for some exercise seems downright unappealing. You know you should; it's good for the body and spirit, but sometimes the motivation just isn't there. But once you've pulled on your gear and headed out the door, it doesn't take long to get lost in the meditative rhythm of your own breath.

For people with traumatic brain injury (TBI), getting regular exercise is especially important. In the late 1990s, Trisha Meili, who sustained a severe brain injury after being attacked in 1989, approached Wayne Gordon, PhD, Jack Nash Professor of Rehabilitation Medicine at Mount Sinai School of Medicine, and Dick Traum, PhD, founder of the Achilles Track Club, an organization created to enable people with all types of disabilities to participate in mainstream athletics.

"Trisha came to us with the notion that exercise had really helped her recovery and wanted to know if there was any research on the physical and cognitive benefits of exercise after brain injury," says Dr. Gordon. "The answer was no." So, in a study they were conducting on the quality of life of individuals with TBI, they included several questions about exercise. The findings showed that exercise was helping the participants' cognition and mood. In fact, the TBI group who exercised reported the same low levels of depression as the group of non-TBI participants who exercised. In addition, the TBI group who exercised also experienced fewer symptoms of cognitive impairment.

Currently, Dr. Gordon is taking this work further in a new study. "We're looking specifically at how exercise affects mood, cognition, and fatigue in people with brain injury," he says. "We have learned that exercise can be seen as a 'curative' treatment for depression and cognitive function. Now, we'll probe deeper and also see what it tells us about fatigue."

"In animal studies, exercise has been shown to promote growth in part of the hippocampus. There’s been one study like this that was replicated in humans," Dr. Gordon says. "The hope is to continue with this research and ultimately tie it into what we are learning about neuroplasticity."

Dr. Traum has a great deal of anecdotal evidence to support the findings that exercise is beneficial for recovery after brain injury. He remembers several people with TBI who were training for a marathon through the Achilles who showed significant progress on many fronts — from problem-solving and cognitive issues to social skills. "We started to notice they were improving when they stopped laughing at my bad jokes," smiles Dr. Traum.

"I remember one guy who was having major problems with his parents," says Dr. Traum. "They were very controlling, and he was fighting to reclaim his independence. After he started training with Achilles, he gained more confidence in himself — physically and emotionally. He started to make friends. Soon, he stopped butting heads with his parents and learned to find a balance between letting them be a part of his life and showing them that he could handle his independence." Other participants returned to work, one man learned to pace himself — in running and in life — and, according to Dr. Traum, Trisha became noticeably more social. Trisha, the founding board chair of Achilles, is still someone Dr. Traum turns to when he wants advice about the Achilles group. "She is sharp, kind, and quite astute at interpersonal relationships," he says.

Five years ago, Dr. Traum took his experience and empirical knowledge to Walter Reed Army Medical Center. Since then, Achilles has welcomed to their running program more than 390 disabled veterans, many of them amputees and a good portion of them with TBI. "People in the Armed Forces are taught that they will never succeed — or survive — unless they are an integral part of a cohesive group," says Dr. Traum, who has a background in behavioral sciences and a prosthetic leg. "With Achilles, we’re giving service members the opportunity to rejoin a group and have a goal. Instead of worrying about their next surgery, they can concentrate on a goal. I'd say two of the most potent tools for recovery are being part of a group and setting goals." Founded in 1984, Achilles has a presence in more than 70 countries and in more than 25 locations nationwide.

In 2003, Trisha with Achilles founded the Hope and Possibility 5M Run/Walk "to replicate the same sense of accomplishment, hope, and possibility she felt running with Achilles during rehabilitation." In 2008, more than 4,000 people participated &mdash on foot, on crutches, in hand-crank wheelchairs, or on one or two artificial limbs. "When someone who has been told he might never walk or talk again crosses the finish line of a race or marathon," says Dr. Traum. "Well ... come out and watch. Their glowing faces will give them away."