Using Activity Diaries to Measure Children's and Adolescents' Compliance With Activity Restrictions After Mild Traumatic Brain Injury

Purpose: To examine the extent to which children and adolescents with a mild traumatic brain injury (MTBI) comply with the activity restrictions received upon discharge from a pediatric trauma center. Participants: Thirty-four children with MTBI (aged 8-16 years) and 34 control children matched for age, sex, and premorbid level of physical activity. Main Measure: Activity diary documenting the exact level of activity during 3 consecutive days during the 1st, 4th, and 12th week post-MTBI (corresponding time intervals for controls) and the Physical Activity Questionnaire. Results: Fifteen pairs of children (MTBI + control) completed the diaries for all 3 assessment times (77% participation rate among consecutive admissions and 44% compliance rate with diary completion). Although some children engaged in activities before the end of the 4-week restriction period, the majority of the children followed the recommendations they received. Children with MTBI maintained a lower level of energy expenditure at the 1- and 4-week evaluations than did the noninjured children, but not at the 12-week evaluation. Conclusion: Children with MTBI usually comply with the activity restrictions they receive upon discharge from the hospital.