Acquired Brain Injury / Traumatic Brain Injury

Why Physical Activity is Important to People with ABI /TBI

A person with an ABI can be at risk of a sedentary lifestyle which makes them prone to secondary health complications. Studies have shown that those with ABI/TBI are often not active enough to receive the health benefits that can be derived from an active lifestyle.

Being physically active can provide a person who has had an ABI/TBI with the same physical, social and cognitive benefits as the general population so it is important for physical activity leaders to understand the impact of ABI/TBI on a person's desire to be active and ability to do so.

Teaching and Communication Techniques for Physical Activity Leaders

The following are ideas for ensuring maximum participation for people with an ABI/TBI, depending on their abilities. You can use these strategies in combination:

  • Involve the person in physical activity goal setting - make sure goals are realistic. It may be helpful to provide some options for goals that they can choose from;
  • Educate about the importance of physical activity to the individual and their family;
  • Know the individual's strengths and limitations - remember that everyone will have different limitations as a result of an ABI/TBI;
  • Be patient. Listen to the person and encourage them to communicate their needs to you - they are the experts at what they need, not you!
  • Lack of initiation can be a major difficulty for a person living with the effects of ABI/TBI. Provide positive encouragement and support at all times;
  • Memory - write instructions down, and provide visual cues. If the participant asks a question, provide the answer. Letting the person guess the wrong answer several times will reinforce wrong information;
  • Comprehension - break down the activity into steps and keep instructions very simple. Use repetition and make sure to link verbal instructions with visual demonstrations;
  • Inattention - minimize distractions during the activity, and try to keep things consistent;
  • Limited concentration - provide frequent breaks and opportunity for rest.
  • Emotional - encourage success and mastery during physical activity in order to limit frustration;
  • Social behaviour - use smaller groups and reinforce socially appropriate behaviour. Encourage others to be patient and helpful. Provide a structured environment and set limits.

Modifying Leisure, Sport and Recreation Activities

  • Recovery from ABI/TBI is unpredictable and changes frequently, so make sure you are always aware of the person's present strengths and limitations;
  • Concentrate on the person's abilities in order to promote success and confidence;
  • Keep it simple - especially for people who have limitations with memory and concentration. For example, decrease the number of steps in an activity and limit distractions.
  • Physical limitations and fatigue - modify aspects of the activity to match with the person's physical abilities to promote success (i.e. lighter equipment, change size of activity area).
  • Spasticity - Avoid activities that will increase spasticity in the muscles (i.e. quick jerky movements and jumping), encourage intermittent relaxation and stretching.

More About ABI/TBI

What is ABI/TBI?

Acquired brain injury (ABI) includes traumatic or non-traumatic events.  A traumatic brain injury (TBI) is an injury to the brain caused by an external force, such as a sports injury,  a motor vehicle crash, a fall, an assault or a gunshot wound.  Non-traumatic brain injury is an internal injury to the brain itself, which can be the result of a stroke, loss of oxygen to the brain (hypoxic brain injury), meningitis or other causes.   An ABI usually causes permanent damage to the brain and results in compromised functioning.

Impact of ABI/TBI

A person's abilities may change a great deal following an ABI/TBI. These changes can be pronounced or mild.

People with an ABI/TBI may have difficulty remembering things. They may not remember your name, or what they are suppose to be doing. It is important to understand that often this behaviour is not intentional.

People with ABI/TBI may have a hard time performing tasks that may appear simple to others (i.e. making a sandwich). Remember, they may have motor difficulties (i.e. difficulties controlling their body) and/or difficulties remembering or sequencing the steps to certain tasks.

People with ABI/TBI are aware of things they could do in the past, but which they may have difficulty with now. Try to understand how frustrating this might be for them.

There is a difference between ABI/TBI and a learning disability. Someone with an ABI/TBI has experienced trauma, their abilities have changed, and they need help to readjust their life post-injury.

A person with an ABI/TBI may present with a combination of the following issues:

  • Spasticity - some people with ABI have abnormal muscle tone, and quite often, high muscle tone (i.e. spasticity). Spasticity is very debilitating and can severely restrict the person's range of motion and ability to take part in daily activities.
  • People who have experienced an ABI/TBI may face feelings of frustration and failure because they are not able to function as they did prior to their injury.
  • Common issues faced may include:
  • Cognitive (problems with memory, initiation, concentration, organization, and comprehension);
  • Motor (difficulty moving and using certain parts of the body);
  • Behavioural (depression, irritability, inability to sit still)
  • Difficulties with communication.

Useful Information About ABI/TBI

  • Approximately 1.5 million people in Canada are living with a brain injury.
  • ABI / TBI is one of the leading causes of disability in children and young adults.
  • Each year, 160,000 Canadians incur an ABI with the majority being young adults.


Ontario Brain Injury Association -
Ontario Neurotrauma Foundation -
What is Brain Injury -
Physical Activity and Traumatic Brain Injury -
National Consortium for Physical Education and Recreation for Individuals with Disabilities (1995). Adapted Physical Education National Standards. Champaign, IL: Human Kinetics.
Lieberman, L.J. and Houston-Wilson, C. (2002). Strategies for Inclusion; A Handbook for Physical Educators. Champaign, IL: Human Kinetics.

Helping Canadians with Disability/Chronic Disease Get Physically Active

For Canadians with a disability, regular physical activity may be even more important than it is for the rest of the population. For a person with a disability, an active lifestyle can open doors to increased health, social inclusion and self-empowerment - doors which might otherwise remain closed. Access to physical activity can eliminate the likelihood of acquiring secondary health conditions like diabetes, high blood pressure or heart disease. Being active builds resiliency and can provide an all-important outlet for a person with a disability.


This project would not have been possible without the expertise of our partners. ALACD would like to sincerely thank these organizations for working with us to develop this resource: the Ontario Blind Sports Association, Variety Village, the National Network for Mental Health, and the Learning Disabilities Association of Canada.