Impact of a Digitally Monitored Walking Program on Functional and Psychological Outcomes in Individuals With Mild
Hsin-Ya Tzeng1, Cheng-Chun Chang2, Sy-Chou Chen3
1Department of Nursing, Tri-Service General Hospital, School of Nursing, National Defense Medical University, Taipei, Taiwan; Graduate Institute of Nursing, College of Nursing, National Defense Medical University, Taipei, Taiwan.
Objective:
To evaluate the effects of a 12-week digital walking exercise program on functional capacity and psychological health in individuals with mild traumatic brain injury (mTBI) and the influence of exercise adherence.
Design:
Randomized controlled trial with repeated measures.
Setting:
Medical center-based recruitment with home-based intervention.
Participants:
Fifty-two adults (N=52) (mean age ± SD, 43.98±14.94y; 57.7% women) diagnosed with mTBI (Glasgow Coma Scale score, 13-15) within 6 months postinjury.
Interventions:
Participants were randomly assigned to either a digitally monitored walking program group (structured walking ≥30min/session, ≥3times/wk, supported by a wearable fitness tracker and personalized feedback) or an active control group receiving standard exercise education.
Main Outcome Measures:
The primary outcome was functional capacity measured by the 6-minute walk test (6MWT). Secondary outcomes included depressive symptoms (Beck Depression Inventory-II) and quality of life (QoL; World Health Organization QoL-Brief Version). Assessments were conducted at baseline and at 4, 8, and 12 weeks. Generalized estimating equations assessed between-group differences. Subgroup analyses evaluated outcomes in participants with ≥80% adherence to moderate-intensity exercise.
Results:
The intervention group demonstrated significantly greater improvements in 6MWT distance at 4 weeks (+41.65m, P=.02), 8 weeks (+61.31m, P=.001), and 12 weeks (+65.29m, P=.003) compared with controls. Between-group differences in depressive symptoms and psychological QoL were not statistically significant. However, in the high adherence subgroup (≥80%), significant improvements were observed in functional capacity, as measured by the 6MWT, as well as in depressive symptoms and overall QoL.
Conclusions:
A 12-week digital walking exercise program significantly improved functional capacity in individuals with mTBI. Psychological health benefits were evident among those with high adherence to moderate-intensity walking. These findings support the integration of wearable technologies and remote monitoring tools into structured rehabilitation to promote functional recovery from mTBI.
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