Recreational physical activities among children with a history of severe traumatic brain injury.

Objective: To describe leisure time physical activity (LTPA) and physical capabilities such as balance, muscle strength and walking performance and to evaluate the associations between physical capabilities and LTPA among children post-traumatic brain injury (TBI) as compared to a peer group of typically-developed (TD) controls. Participants: Convenience sample of 15 children, 1.5-7 years post-severe TBI and 15 age- and sex-matched controls. Main outcome measures: LTPA by the Godin and Shephard (G&S) questionnaire. Balance tests-the Timed Up and Go test (TUG) and functional reach test (FRT). Maximal isometric strength was assessed by using a hand-held dynamometer; walking dynamics were recorded by an electronic mat and the 6 minute walk test and energy expenditure index (EEI). Perceived exertion was rated by the OMNI scale. Results: Children post-severe TBI participate significantly less in LTPA as compared to TD controls (p < 0.01). Walking performance was comparable between groups except for step length which was significantly shorter among children post-TBI. Hip extensor strength and balance performance were significantly lower among children post-TBI. Balance performance was positively associated with LTPA. Conclusions: This study suggests that attention should be directed towards improving balance performance as part of the training repertoire of children and adolescents with post-severe TBI. The efficacy of such a training programme, in particular its contribution to LTPA participation, should then be further assessed.