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Psychological Resilience Moderates Autonomous Motivation After Mild Traumatic Brain Injury: A Randomized Controlled

Ya-Ching Chang1, Hsin-Fang Tsai, Rui-Shan Shi

  • 1Author Affiliations: Graduate Instutute of Nursing, College of Nursing, National Defense Medical University, Neihu District, Taipei, Taiwan (Chang, Shi, Tsai, and Chiang); Department of Nursing, Tri-Service General Hospital, Neihu District, Taipei, Taiwan (Chang and Shi); Department of Nursing, Kaohsiung Armed Forces General Hospital, Zuoying District, Kaohsiung, Taiwan (Tsai); Department of Physical Education and Sports Sciences, National Taiwan Normal University, Taipei City, Taiwan (Chi); Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical University, Neihu District, Taipei, Taiwan (Hueng); and School of Mathematics, Tamkang University, Yingzhuan Road, Tamsui District, New Taipei City, Taiwan (Chang).

The Journal of Head Trauma Rehabilitation
|March 19, 2026
PubMed
Summary

A 12-week remote walking program did not significantly improve autonomous exercise motivation in adults with mild traumatic brain injury (mTBI). However, higher baseline psychological resilience enhanced the program's effect on autonomous motivation.

Keywords:
exercise motivationpsychological resiliencerandomized controlled trialself-determination theorytraumatic brain injury

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Behavioral Psychology

Background:

  • Mild traumatic brain injury (mTBI) often leads to reduced physical activity and motivation.
  • Self-determination theory (SDT) provides a framework for understanding motivation in health behaviors.
  • Remote interventions offer accessible options for individuals with mTBI.

Purpose of the Study:

  • To assess if a 12-week remote walking program, guided by SDT, enhances autonomous exercise motivation in adults with mTBI.
  • To determine if baseline psychological resilience moderates the intervention's effect on motivation.
  • To examine the program's impact on controlled motivation and resilience.

Main Methods:

  • A single-center, randomized controlled trial involving 73 adults with mTBI.
  • Participants were randomized to either a 12-week remote walking program (using a fitness bracelet and messages) or an active control (health education).
  • Primary outcome: autonomous exercise motivation. Secondary outcomes: controlled motivation and psychological resilience, assessed at baseline, 3, and 6 months.

Main Results:

  • No significant difference in autonomous motivation between the intervention and control groups post-intervention.
  • Controlled motivation significantly increased in the intervention group at 6 months compared to baseline.
  • Baseline psychological resilience significantly moderated the treatment effect on autonomous motivation, indicating a stronger positive impact in resilient individuals.

Conclusions:

  • The remote walking program did not significantly improve autonomous motivation overall but increased controlled motivation at 6 months.
  • Baseline psychological resilience is a key factor in strengthening the motivational benefits of such programs.
  • Integrating resilience-building strategies may enhance adherence and long-term outcomes in mTBI rehabilitation.