Effectiveness of Neurofeedback-Assisted Exercise vs. Traditional Exercise in the Rehabilitation of Post-Traumatic Brain Injury Patients

Abstract

Background: Post-traumatic brain injury (TBI) often results in long-term cognitive, motor, and emotional impairments that substantially reduce independence and quality of life. Traditional exercise (TE) is a mainstay of rehabilitation, but its capacity to address multidimensional recovery is limited. Neurofeedback-assisted exercise (NAE), which integrates real-time cortical activity modulation with structured physical training, may provide synergistic benefits by simultaneously targeting neural regulation and physical performance. Objective: To compare the effectiveness of NAE versus TE in improving cognitive function, motor independence, and emotional well-being among patients with post-TBI. Methods: A randomized controlled trial enrolled 60 adults with moderate TBI deficits, randomly assigned to NAE (n=30) or TE (n=30) groups for 10 weeks, with three 45-minute sessions weekly. Outcomes included cognitive function (Mini-Mental State Examination, MMSE), motor function (Functional Independence Measure, FIM), and emotional well-being (Profile of Mood States, POMS). Independent t-tests with 95% confidence intervals and effect sizes were used for analysis. Results: Both groups improved significantly, but NAE produced larger gains: MMSE +5.9 vs +2.7 (p<0.001), FIM +11.9 vs +7.5 (p<0.001), and POMS −12.4 vs −6.3 (p<0.001). Effect sizes were largest for NAE in emotional outcomes (d=3.15). Conclusion: NAE provided superior cognitive, motor, and emotional benefits compared with TE, supporting its potential as a holistic rehabilitation strategy for TBI.