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Moderate\u2010to\u2010vigorous aerobic exercise (MVAE) is a modifiable behavior with potential benefits for individuals following mTBI but is poorly understood for long\u2010term mTBI health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the associations between mTBI history and MVAE participation and appreciate their association with health\u2010related quality of life (HR\u2010QOL) among service members and Veterans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from a larger study were used in these secondary cross\u2010sectional analyses. Lifetime mTBI history (0, 1\u20132, 3+) was captured via validated structured interviews. Self\u2010reported weekly MVAE (none, below, meeting, or \u22652 times the recommendation) was recorded from the Behavioral Risk Factor Surveillance System questionnaire. Participants\u2019 HR\u2010QOL was self\u2010reported via Traumatic Brain Injury\u2010Quality of Life instrument and the Patient Health Questionnaire\u20109 (depression symptoms). Univariate mTBI history and MVAE associations were assessed via Pearson's chi\u2010square and Kendall's Tau. Multivariable linear regression models with unstandardized beta values and 95% confidence intervals were fit for each HR\u2010QOL questionnaire outcome, with current age, sex, and posttraumatic stress disorder symptoms as covariates (\u03b1\u2009=\u2009.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 1995 participants (87.7% male; aged 41.7\u2009\u00b1\u200910.1\u2009years), those meeting or exceeding (\u22652 times) MVAE recommendations had significantly higher HR\u2010QOL for fatigue, executive function, pain interference, resilience, social participation, and depression than the inactive MVAE group. Exceeding MVAE recommendations by \u22652 times was also significantly associated with better self\u2010reported cognition \u2013 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\u2010QOL across all domains. Level of MVAE participation was not dependent on mTBI history.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>More MVAE was associated with better TBI\u2010related HR\u2010QOL regardless of mTBI history. MVAE is recommended for service members and Veterans due to these findings and previously reported health benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmrj.13436","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T12:33:43Z","timestamp":1755779623000},"page":"33-43","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Associations among aerobic physical activity, mild traumatic brain injury history, and health\u2010related quality of life in military service members and Veterans: A\n                    <scp>LIMBIC<\/scp>\n                    \u2010\n                    <scp>CENC<\/scp>\n                    study"],"prefix":"10.1002","volume":"18","author":[{"given":"Brendan E.","family":"Casola","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University School of Medicine  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University School of Medicine  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Fraser","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Uniformed Services University of the Health Sciences School of Medicine  Bethesda Maryland USA"},{"name":"University of Kentucky Sports Medicine Research Institute  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie R.","family":"Oldham","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University School of Medicine  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Landon B.","family":"Lempke","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University School of Medicine  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra F.","family":"DeJong Lempke","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University School of Medicine  Richmond Virginia USA"},{"name":"Richmond VA Medical Center  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David X.","family":"Cifu","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University School of Medicine  Richmond Virginia USA"},{"name":"Richmond VA Medical Center  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University School of Medicine  Richmond Virginia USA"},{"name":"Richmond VA Medical Center  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel R.","family":"Walton","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University School of Medicine  Richmond Virginia USA"},{"name":"Richmond VA Medical Center  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Department of Defense.DOD Numbers for Traumatic Brain Injury Worldwide. 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