Examining Leisure Re-Engagement and Its Relationship With Self-Regulation After Traumatic Brain Injury: A Cross-Sectional Study

Abstract

Engagement in leisure activities is a significant contributor to health. Individuals with traumatic brain injury (TBI) report not returning to pre-injury levels of leisure participation. Self-regulation (SR) is a possible factor of limited re-engagement. This study aimed to examine leisure re-engagement patterns and the impact of SR on these patterns. Fifty-five adults with TBI were included in a cross-sectional study. Participants completed a leisure activity survey, rating engagement before and after injury. Participants and an informant completed the Frontal Systems Behavior Scale (FrSBe) to assess SR. Leisure was significantly lower after injury than before injury, t(54) = 3.83, p < .001. The FrSBe apathy score was significantly associated with lower re-engagement (eta = 0.42) and may predict engagement after injury (ΔR² = .09, p < .05). Apathy may contribute to difficulty re-engaging in leisure activities. Re-engagement in leisure activities should be a focus of occupational therapy intervention after TBI.

Plain Language Summary

How Traumatic Brain Injury Affects Leisure Activities and Self-Regulation

This study looks at how people who have had a traumatic brain injury (TBI) get back into leisure activities (such as hobbies, sports, and social engagements). Furthermore, this study looks at how a person’s ability to self-regulate impacts their ability to participate in leisure tasks. Self-regulation is how an individual is able to control their thoughts, actions, and emotions and includes three components addressed in this study: executive functioning, apathy, and disinhibition. Leisure activities are important for health and well-being. However, many people with TBI find it hard to return to these activities due to their impairments. We interviewed 55 adults with TBI about their leisure activities before and after their injury. They also completed a questionnaire with their family members to assess their self-regulation abilities, such as planning, monitoring, and changing their actions to meet their goals. The results showed that people engaged in leisure activities significantly less after their injury than before they were injured. We found that higher levels of apathy were linked to lower levels of re-engagement in leisure activities. In other words, those who demonstrated a lack of interest or enthusiasm were less likely to return to their hobbies and interests. These findings suggest that apathy plays a big role in whether someone with TBI will re-engage in leisure activities. Because of this, occupational therapists should include interventions and strategies to help manage apathy and encourage participation in leisure activities for better quality of life and outcomes.