Evidence map›Paper›PMID 40838673›Full record

ArticlePM & R : the journal of injury, function, and rehabilitation2026

Associations among aerobic physical activity, mild traumatic brain injury history, and health-related quality of life in military service members and Veterans: A LIMBIC-CENC study.

Brendan E Casola, Michael J Hall, John J Fraser, Jessie R Oldham, Landon B Lempke, Alexandra F DeJong Lempke, David X Cifu, William C Walker, Samuel R Walton

Abstract read
In one paragraph

Article in PM & R : the journal of injury, function, and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Brendan E CasolaDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
Michael J HallDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
John J FraserDepartment of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, Maryland, USA.
Jessie R OldhamDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
Landon B LempkeDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
Alexandra F DeJong LempkeDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
David X CifuDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
William C WalkerDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
Samuel R WaltonDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.

Funding

CSRD VA I01 CX001135CSRD VA I01 CX001246CSRD VA I01 CX002096CSRD VA I01 CX002097HSRD VA I01 HX003155RRD VA I01 RX001135RRD VA I01 RX001774RRD VA I01 RX001880RRD VA I01 RX002076RRD VA I01 RX002170RRD VA I01 RX002171RRD VA I01 RX002172RRD VA I01 RX002173RRD VA I01 RX002174RRD VA I01 RX003442RRD VA I01 RX003443RRD VA I01 RX003444U.S. Department of Defense W81XWH-13-2-0095U.S. Department of Defense W81XWH1920067U.S. Department of Veterans Affairs I01 RX 001135U.S. Department of Veterans Affairs I01 RX 001880U.S. Department of Veterans Affairs I01 RX 002076U.S. Department of Veterans Affairs I01 RX 002170U.S. Department of Veterans Affairs I01 RX 002171U.S. Department of Veterans Affairs I01 RX 002172U.S. Department of Veterans Affairs I01 RX 002173U.S. Department of Veterans Affairs I01 RX 002174
6 · The paper itself

Abstract

backgroundMild traumatic brain injury (mTBI) is common among military service members. Moderate-to-vigorous aerobic exercise (MVAE) is a modifiable behavior with potential benefits for individuals following mTBI but is poorly understood for long-term mTBI health.

objectiveTo explore the associations between mTBI history and MVAE participation and appreciate their association with health-related quality of life (HR-QOL) among service members and Veterans.

methodsData from a larger study were used in these secondary cross-sectional analyses. Lifetime mTBI history (0, 1-2, 3+) was captured via validated structured interviews. Self-reported weekly MVAE (none, below, meeting, or ≥2 times the recommendation) was recorded from the Behavioral Risk Factor Surveillance System questionnaire. Participants' HR-QOL was self-reported via Traumatic Brain Injury-Quality of Life instrument and the Patient Health Questionnaire-9 (depression symptoms). Univariate mTBI history and MVAE associations were assessed via Pearson's chi-square and Kendall's Tau. Multivariable linear regression models with unstandardized beta values and 95% confidence intervals were fit for each HR-QOL questionnaire outcome, with current age, sex, and posttraumatic stress disorder symptoms as covariates (α = .05).

resultsAmong the 1995 participants (87.7% male; aged 41.7 ± 10.1 years), those meeting or exceeding (≥2 times) MVAE recommendations had significantly higher HR-QOL for fatigue, executive function, pain interference, resilience, social participation, and depression than the inactive MVAE group. Exceeding MVAE recommendations by ≥2 times was also significantly associated with better self-reported cognition - general concerns. Those who participated in exercise but didn't meet the MVAE recommendations had higher pain interference, social participation, and depression scores compared to the inactive group. More lifetime mTBIs were associated with worse HR-QOL across all domains. Level of MVAE participation was not dependent on mTBI history.

conclusionsMore MVAE was associated with better TBI-related HR-QOL regardless of mTBI history. MVAE is recommended for service members and Veterans due to these findings and previously reported health benefits.

Indexed as

Brain ConcussionExerciseMilitary PersonnelQuality of LifeVeteransAdultCross-Sectional StudiesFemaleHumansMaleMiddle AgedSelf ReportSurveys and QuestionnairesUnited States

Identifiers

PMID40838673
PMCPMC12828639

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.