B - 21 11-Year Longitudinal Study of a Competitive Swimmer Following a Severe TBI

Abstract Objective Symptoms of severe traumatic brain injuries (TBIs) are oftentimes significant, long lasting, and treated by a variety of medications and therapies. Although exercise is known to be beneficial for brain health, the effects of substantial exercise on recovery following severe TBI (sTBI) in female athletes are undiscovered. Method This case study examines a 51-year-old woman who sustained a sTBI, involving multiple hemorrhagic contusions to the right cerebellum, inferior bilateral frontal lobes, anterior left temporal lobe, and diffuse axonal injury on 8/5/13 from a bicycle accident, resulting in a 13-day coma and cognitive impairment. She underwent 6 brain surgeries, an artificial skull implant and intensive therapies. Before the accident, she was a competitive swimmer and triathlon racer. Despite being told that she would never swim again, she resumed swimming on 09/1/14. She swims 6 days a week for 90-minutes a day, winning open water races. Results Examination from four neuropsychological assessments over 11 years provide substantial longitudinal data. Results revealed improvement over the 4 testing periods particularly on processing speed, verbal fluency, and Boston Naming Test with t-score differences ranging between 8 and 24. Additionally, she performed in the average range on General Abilities Index, NAB Mazes, and Trail Making Test across all four assessments. Conclusion This longitudinal case study provides evidence that extensive swimming is associated with cognitive recovery from sTBI in a female athlete and documents her return to high level exercise and competition. Evidence suggests that carefully tailored and monitored exercise programs can benefit long term cognitive following from sTBI.