Physical Activity and Traumatic Brain Injury

Posted on May 27, 2020

Physical inactivity, especially after a TBI, can increase the risk of the development of further secondary and chronic health conditions. However, patients with TBI, or those who have suffered a stroke, concussion, or an ABI, face barriers to participation in remaining physically active.

These barriers vary depending on the severity of the injury, type of impairment, age, and length of the initial injury. Post-injury the level of physical activity decreases due to a variety of which may be:

  • Psychosocial- lack of time, energy, interest, and motivation, self-consciousness.
  • Physical impairment- decreased mobility, balance and muscle strength, pain. 
  • Societal level barriers- lack of support, lack of proper trainer or coach, and therapists to suggest proper physical exercises for TBI victims. Lack of availability of adapted physical activity opportunities.
  • Environmental barriers may include a lack of accessible facilities, lack of transportation, and the cost of the program. 

Encouragement on a community level, tailored education, and support from health care professionals about the safety and appropriateness of physical activities could help in overcoming such barriers. Knowledge of activities for those victims who are physically able can increase their confidence in being more active and alleviate other health concerns.   

Benefits of physical activity after a TBI

Physical activity should be strongly considered as an adjunct to rehabilitation, especially in individuals with moderate to severe TBI. Educating patients with TBI on the multi-dimensional benefits of exercise, which include improved learning, improved sleep, managing stress, and development of social skills and improvement in social interaction can help in speeding up the rehabilitation process. 

Patients with TBI who participated in daily physical activities, exercises, and some form of sport show early recovery. In the long term, the benefits of being active enable independent living and greater self-efficacy for exercise.  

Exercise guidelines for individuals with TBI, published by the American College of Sports Medicine, recommends exercising at a frequency of 3-5 times a week. With an intensity of 40-70% oxygen uptake or a 13/20 Rating of Perceived Exertion (RPE) for a duration of 20-60 minutes using an appropriate form of exercise, e.g., swimming, walking, cycling depending on the person’s capacity is recommended.

Types of Exercise

An exercise program must be designed by trained physiotherapists, according to the TBI patient’s specific needs and abilities, keeping in mind the effect of the injury on the tone and spasticity, range of motion and physical endurance, cardiovascular and muscular endurance as well as strength and cognitive impairments.  

Cardiovascular exercises like walking, jogging, cycling, dancing, swimming, or Aerobic classes, help build endurance and excellent for heart health. 

Strength training:

Bodyweight exercises like squats, lunges, resistance bands, resistance training machines, and free weights are effective exercises. These challenge your muscles to push and pull against resistance. It also stimulates bone growth, bone density, lowers blood sugar levels, improves balance and posture, and overall loosens tightened muscles. 


Balance exercises include standing on foot, tandem stance, walking heel to toe, standing on an unstable surface with more relaxing exercises such as Tai Chi and Yoga. 

You will find yourself steadier on your feet and prevent falling. It helps jog up the weakening senses like vision and hearing because some of our muscles and tendons are also impacted.


Flexibility training include Tai Chi, Yoga, and stretching. This will allow you to enhance the maximum movement of a joint and increase muscle length. 

You should keep track of all the changes your body is going through and keep in touch with your physiotherapist at all times.