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Moving Forward: Reclaiming Your Fitness after a Traumatic Brain Injury

Wednesday, March 12, 2025

By Emma Tinney, PhD candidate at Northeastern University

Recovering from a traumatic brain injury (TBI) is about more than just medical treatment—it’s about getting back to daily life, including physical activity. Regaining strength, endurance, and confidence can feel daunting, but regular exercise is one of the keys to improving your brain health, cognitive function, and overall well-being. With the right approach, individuals can safely ease back into movement and enjoy the benefits of an active lifestyle after a TBI. 

The Importance of Exercise after TBI

Physical activity is a powerful way to support your long-term health. Research suggests that regular exercise could prevent up to 5.3 million deaths worldwide each year from non-communicable diseases. Beyond the physical benefits, staying active is crucial for brain health, helping with memory, processing speed, and executive function—areas often impacted by TBI1,2,3,4.

However, many people with TBI face challenges making it harder to stay active, such as cognitive difficulties, physical limitations, and environmental barriers. Finding practical solutions to these obstacles can make exercise more accessible and sustainable.

Common Challenges to Exercise after TBI

  1. Cognitive Barriers:
    • Difficulty planning and sticking to exercise routines due to executive functioning5
    • Memory issues that make it hard to remember workout schedules or goals
    • Attention deficits can make structured or group activities feel overwhelming6
  2. Physical Barriers:
    • Challenges with movement due to motor impairments, balance issues, or chronic pain7
    • Fatigue, a common consequence of TBI, can make exercise feel exhausting rather than energizing
  3. Environmental Barriers:
    • Limited access to adaptive fitness programs and
    • Lack of social support, which may reduce motivation to engage in exercise8,9

Without regular exercise, individuals with TBI are at higher risk for cardiovascular disease, metabolic syndrome, and neurodegeneration—conditions which are especially common in this population10. Inactivity can also impact cognitive and emotional resilience, potentially worsening disability over time.

The Cognitive Benefits of Exercise in TBI Recovery 

While more research is needed, studies suggest that exercise can support cognitive function11,12,13,14, particularly in:

  • Thinking and decision-making skills (how quickly you process information, adapt to changes, and control impulses)
  • Memory (short-term memory for daily tasks and long-term memory for past events)
  • Reaction time and coordination (how fast you respond to things and how well your brain and body work together)

For individuals with TBI, these benefits may be even more significant due to the brain’s ability to adapt after injury. However, not all cognitive challenges improve equally with exercise. For example, if memory is a primary concern, combining physical activity with cognitive rehabilitation may be especially helpful.

Practical Tips for Safely Resuming Exercise after TBI

  1. Start Slow & Listen to Your Body
    • Begin with low-impact activities like walking, gentle yoga, or seated exercises
    • Pay attention to signs of fatigue, dizziness, or headache, and adjust accordingly
  2. Create a Structured Routine
    • Use reminders, apps, or written schedules to keep track of workouts
    • Set small, achievable goals to build consistency and confidence
  3. Incorporate Balance & Coordination Training
    • Exercises like tai chi or stability ball movements can help improve balance and reduce fall risk
  4. Modify Workouts to Accommodate Physical Challenges
    • Adaptive equipment and seated exercises can provide accessible options
    • Resistance bands and body-weight movements can help rebuild strength safely
  5. Engage in Social or Supervised Exercise
    • Working out with a friend, caregiver, or physical therapist can provide motivation and support
    • Group classes tailored to individuals with neurological conditions may offer a sense of community
  6. Monitor Progress & Adjust as Needed
    • Track improvements in endurance, strength, or daily energy levels.
    • Celebrate small milestones to stay motivated

Moving Forward with Confidence 

Reclaiming your fitness after a TBI is a journey that requires patience, adaptation, and resilience. While challenges exist, they can be navigated with the right strategies and support. By gradually incorporating movement into daily life, individuals with TBI can experience the profound benefits of exercise—not just for physical health, but for cognitive function, emotional well-being, and overall quality of life.

If you’re on this journey, know that progress is possible! With every step forward, you’re that much closer to reclaiming strength, confidence, and independence.

You can download this helpful infographic here.

References:

  1. Cabral DF, Rice J, Morris TP, Rundek T, Pascual-Leone A, Gomes-Osman J. Exercise for Brain Health: An Investigation into the Underlying Mechanisms Guided by Dose. Neurotherapeutics. 2019;16(3):580-599. doi:10.1007/s13311-019-00749-w
  2. Erickson KI, Hillman C, Stillman CM, et al. Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines. Med Sci Sports Exerc. 2019;51(6):1242-1251. doi:10.1249/MSS.0000000000001936
  3. Bherer L, Erickson KI, Liu-Ambrose T. A Review of the Effects of Physical Activity and Exercise on Cognitive and Brain Functions in Older Adults. J Aging Res. 2013;2013. doi:10.1155/2013/657508
  4. Gomez-Pinilla F, Hillman C. The Influence of Exercise on Cognitive Abilities. Compr Physiol. 2013;3(1):403-428. doi:10.1002/cphy.c110063
  5. Stuss DT. Traumatic brain injury: relation to executive dysfunction and the frontal lobes. Curr Opin Neurol. 2011;24(6):584. doi:10.1097/WCO.0b013e32834c7eb9
  6. Allan JL, McMinn D, Daly M. A Bidirectional Relationship between Executive Function and Health Behavior: Evidence, Implications, and Future Directions. Front Neurosci. 2016;10. doi:10.3389/fnins.2016.00386
  7. Basford JR, Chou LS, Kaufman KR, et al. An assessment of gait and balance deficits after traumatic brain injury. Arch Phys Med Rehabil. 2003;84(3):343-349. doi:10.1053/apmr.2003.50034
  8. Burgess C, Tian EJ, Tyack E, Kumar S. Barriers and enablers to physical activity for individuals living with traumatic brain injury: a mixed methods systematic review. Brain Inj. 2024;38(14):1157-1170. doi:10.1080/02699052.2024.2381053
  9. Hamilton M, Khan M, Clark R, Williams G, Bryant A. Predictors of physical activity levels of individuals following traumatic brain injury remain unclear: A systematic review. Brain Inj. 2016;30(7):819-828. doi:10.3109/02699052.2016.1146962
  10. Kursancew ACS, Faller CJ, Piva-Uchida EM, et al. Metabolic disorders after traumatic brain injury: a narrative review of systemic consequences. Metab Brain Dis. 2025;40(1):93. doi:10.1007/s11011-024-01524-3
  11. Lal A, Kolakowsky-Hayner SA, Ghajar J, Balamane M. The Effect of Physical Exercise After a Concussion: A Systematic Review and Meta-analysis. Am J Sports Med. 2018;46(3):743-752. doi:10.1177/0363546517706137
  12. Morris TP, Tormos Muñoz JM, Cattaneo G, Solana-Sánchez J, Bartrés-Faz D, Pascual-Leone A. Traumatic Brain Injury Modifies the Relationship Between Physical Activity and Global and Cognitive Health: Results From the Barcelona Brain Health Initiative. Front Behav Neurosci. 2019;13. doi:10.3389/FNBEH.2019.00135
  13. Morris T, Gomes Osman J, Tormos Muñoz JM, Costa Miserachs D, Pascual Leone A. The role of physical exercise in cognitive recovery after traumatic brain injury: A systematic review. Restor Neurol Neurosci. 2016;34(6):977-988. doi:10.3233/RNN-160687
  14. Sharma B, Allison D, Tucker P, Mabbott D, Timmons BW. Cognitive and neural effects of exercise following traumatic brain injury: A systematic review of randomized and controlled clinical trials. Brain Inj. 2020;34(2):149-159. doi:10.1080/02699052.2019.1683892