Understanding factors influencing the return to physical activity, perspectives of adults with concussion/mild traumatic brain injury: A qualitative study

Understanding the factors that influence the return to physical activity can help to modify behaviour to enhance the recovery of symptoms and physical activity. We conducted 14 semi-structured interviews to explore the barriers and facilitators to returning to physical activity in adults following a mild traumatic brain injury (TBI). The study design was informed by the Theoretical Domains Framework and Capability, Opportunity and Motivation-Behaviour model. Ten key factors were identified in the analysis: four factors consistently acted as barriers (fatigue, sensory overload, symptoms, social expectations), four as facilitators (physical activity, assistive items, social support, health professional support), and two demonstrated a more complex, bidirectional influence (mental health, environment). These ten factors were organized to four overarching thematic groups: intrinsic factors, environmental and adaptive factors, social influences and symptom management. Adults with symptoms lasting greater than 10 days post-mild TBI report that a combination of symptoms, including fatigue and sensory overload prevent their ability to return to physical activity. The environment, social support structures, and access to health professional support facilitated individuals with returning to their physical activities. These findings should be considered when providing interventions to patients in clinical practice to enhance patients' recovery of symptoms and physical activity.