{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:04:24Z","timestamp":1781870664396,"version":"3.54.5"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"Supplement_6","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Because chronic difficulties with cognition and well-being are common after mild traumatic brain injury (mTBI) and aerobic physical activity and exercise (PAE) is a potential treatment and mitigation strategy, we sought to determine their relationship in a large sample with remote mTBI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>The Long-Term Impact of Military-Relevant Brain Injury Consortium\u2013Chronic Effects of Neurotrauma Consortium prospective longitudinal study is a national multicenter observational study of combat-exposed service members and veterans. Study participants with positive mTBI histories (n\u2009=\u20091,087) were classified as \u201cinactive\u201d (23%), \u201cinsufficiently active\u201d (46%), \u201cactive\u201d (19%), or \u201chighly active\u201d (13%) based on the aerobic PAE level. The design was a cross-sectional analysis with multivariable regression. PAE was reported on the Behavioral Risk Factor Surveillance System. Preselected primary outcomes were seven well-validated cognitive performance tests of executive function, learning, and memory: The California Verbal Learning Test\u2014Second Edition Long-Delay Free Recall and Total Recall, Brief Visuospatial Memory Test\u2014Revised Total Recall, Trail-Making Test\u2014Part B, and NIH Toolbox for the Assessment of Neurological Behavior and Function Cognition Battery Picture Sequence Memory, Flanker, and Dimensional Change Card Sort tests. Preselected secondary outcomes were standardized self-report questionnaires of cognitive functioning, life satisfaction, and well-being.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Across the aerobic activity groups, cognitive performance tests were not significantly different. Life satisfaction and overall health status scores were higher for those engaging in regular aerobic activity. Exploratory analyses also showed better working memory and verbal fluency with higher aerobic activity levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>An association between the aerobic activity level and the preselected primary cognitive performance outcome was not demonstrated using this study sample and methods. However, higher aerobic activity levels were associated with better subjective well-being. This supports a clinical recommendation for regular aerobic exercise among persons with chronic or remote mTBI. Future longitudinal analyses of the exercise\u2013cognition relationship in chronic mTBI populations are recommended.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usad056","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T15:01:02Z","timestamp":1699628462000},"page":"124-133","source":"Crossref","is-referenced-by-count":6,"title":["Relation of Aerobic Activity to Cognition and Well-being in Chronic Mild Traumatic Brain Injury: A LIMBIC-CENC Study"],"prefix":"10.1093","volume":"188","author":[{"given":"Brennan M","family":"Wright","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation (PM&R), Virginia Commonwealth University , Richmond, VA 23284-0667, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah , Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renae R","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Thomas Jefferson University Sidney Kimmel Medical College , Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amol M","family":"Karmarkar","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation (PM&R), Virginia Commonwealth University , Richmond, VA 23284-0667, USA"},{"name":"Sheltering Arms Institute , Richmond, VA 23233, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M","family":"Bjork","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation (PM&R), Virginia Commonwealth University , Richmond, VA 23284-0667, USA"},{"name":"Mental Health Service, Central Virginia VA Health Care System , Richmond, VA 23249, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Jo","family":"Pugh","sequence":"additional","affiliation":[{"name":"VA Salt Lake City IDEAS Center for Innovation and Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City, UT 84312, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cooper B","family":"Hodges","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation (PM&R), Virginia Commonwealth University , Richmond, VA 23284-0667, USA"},{"name":"Research Service Line, Washington DC VA Medical Center , Washington, DC 20422, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah L","family":"Martindale","sequence":"additional","affiliation":[{"name":"Research & Academic Affairs Service Line, W. G. (Bill) Hefner VA Healthcare System , Salisbury, NC 28144, USA"},{"name":"Department of Physiology and Pharmacology, Wake Forest School of Medicine , Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth A","family":"Wilde","sequence":"additional","affiliation":[{"name":"George E. Wahlen VA Salt Lake City Healthcare System , Salt Lake City, UT 84148, USA"},{"name":"Department of Neurology, University of Utah , Salt Lake City, UT 84132, USA"},{"name":"H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine , Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimbra","family":"Kenney","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"National Intrepid Center of Excellence, Walter Reed National Military Medical Center , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation (PM&R), Virginia Commonwealth University , Richmond, VA 23284-0667, USA"},{"name":"Mental Health Service, Central Virginia VA Health Care System , Richmond, VA 23249, USA"},{"name":"Department of Psychology, Virginia Commonwealth University , Richmond, VA 23284, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall S","family":"Scheibel","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Utah , Salt Lake City, UT 84132, USA"},{"name":"Michael E. 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