The ADHD Lifestyle Part I: Diet

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The ADHD Lifestyle Part I: Diet

The ADHD Lifestyle Part I: Diet

The brain is vital organ that, like the other organs in the body, depend on nutrients for healthy function and endurance. Those with ADHD are even more dependent on proper nutrients and sleep. Cognition, memory, and mood may all be affected by eating well. More importantly, unhealthy eating and poor sleep can exacerbate ADHD symptoms and make a profound difference in academic success. Studies have shown that the elimination of processed sugars and other unwholesome foods improve ADHD symptoms in the majority of study participants. Why does diet make such a profound impact? Food influences the chemicals in the brain that are involved in ADHD. Importantly, serotonin and dopamine are the major players here. In addition to influencing ADHD symptoms, serotonin levels can also influence sleep behavior.

While not technically a drug, healthy nutrients in everyday food can be thought of as a potent “medication” that may profoundly impact the performance of one with ADHD. In this light, it is important for one to take his or her “daily dose.” This includes plenty of drinking water, complex carbohydrates, and lean protein gradually and consistently taken in on daily basis. Such behavior will increase positive sleeping behavior while keeping serotonin and dopamine at advantageous levels. Conversely, simple sugars like candy or soda, may create an initial spike in these neurotransmitters, but this will be followed by a sharp decline that will leave on craving even more unhealthy food. The result is a “domino effect” and putting the brain in a chemical state that may strengthen the negative behavioral symptoms of ADHD.

Three quick pointers:

*Drink plenty of water and avoid excessive amounts of caffeine and alcohol. Importantly, stay hydrated while avoiding sugary drinks. Sugar drinks are a waste of calories!

*Eat smart: not all calories are the same! It is important to intake a proper amount of daily calories to feed the brain. However, not all calories will affect ADHD symptoms uniformly. Unfortunately for those with ADHD, impulsive tendencies often lead to consumption of simple carbohydrates such as soda, candy, and processed snacks that cause sharp unsustainable increases in blood sugar. On the other hand, complex carbohydrates, such as fruits and vegetables, will have result in more favorable and sustained neurotransmitter levels. Foods high in protein will help control blood sugar levels. When one consistently practices good habits, some of the cravings for “junk food” will be better controlled. Go for those sweet potatoes and blueberries next time you are at the grocery store!

*Get sleep! Food and sleep are intimately related and, together, they both profoundly affect the behavioral and emotional state of those with ADHD.

The Pathways team of professionals has helped thousands of people with brain injuries. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

LET’S GET STARTED

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Source: Pathways Neuropsychology
The ADHD Lifestyle Part I: Diet

Neuropsychologists – Basic Neuropsychology Tools Video

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Neuropsychologists – Basic Neuropsychology Tools Video

This video reviews common tools of the trade for Neuropsychologists. We utilize a comprehensive approach based on proven, research-based methods to rebuild and restore cognitive behavior.

The Pathways team of professionals has helped thousands of people with brain injuries. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

LET’S GET STARTED

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Neuropsychologists – Basic Neuropsychology Tools Video

Defining ADHD in Light of Brain Injuries

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Defining ADHD in Light of Brain Injuries

brain injury adhd

According to the most recent studies, experts define ADHD as a developmental disorder affecting proper use of executive functions. One can think of executive functions as the brain’s “command center,” controlling focus, organization, memory, action, and effort. In short, it is the self-management system of the brain that is tasked with operating unconscious decisions in daily life. As a developmental disorder with a hereditary component, ADHD will present itself as the brain is maturing in childhood. ADHD symptoms are chronic and will often interfere with daily functioning in routine tasks. However, these impairments are situation-dependent. For instance, one with ADHD may show reduced symptoms for an extremely exciting and adrenaline-inducing task, but show carelessness for more mundane, yet essential, tasks.

One of the controversial questions facing experts is: is it possible for adults to develop ADHD later in life if it is truly a developmental disorder? What is definitely true is that adults with no childhood ADHD will report ADHD symptoms later in life: problems starting tasks and projects, estimating time, prioritizing schedule, and completing work without procrastination. Specifically, adults that have experienced menopause or a traumatic brain injury (TBI) are more likely to present with ADHD-like symptoms. Regardless if one wishes to define these cases as ADHD, it is true that events preceding and during adulthood can affect brain function and chemical balance enough to severely impair executive functions. However, treating an adult with TBI and ADHD-like symptoms may add an extra layer of considerations and complexity. For instance, a lot of traditional ADHD treatments may exacerbate TBI symptoms and make the overall condition worse.

A 2015 study in the Journal of Psychiatric Research links TBI with ADHD-like symptoms by interviewing patients in Ontario, Canada. However, the results are not black and white. Some interpret the data and conclude that TBI’s influence the brain’s chemical and structural makeup lead to ADHD-like symptoms. TBI, in these cases, transform one’s psycho-neurological makeup leading to ADHD in adults. Other doctors, however, argue that ADHD patients are more likely to partake in high risk behavior that would lead to TBI’s in the first place. It is a classic debate of the chicken and the egg. Proper classification can be tricky, as both TBI and ADHD exhibit symptoms such as impulsive behavior, memory impairment, organization, and use of executive functions. One who is experiencing ADHD symptoms with a TBI should seek professional consultation to make sure both are treated sufficiently without stressing one or the other.

The Pathways team of professionals has helped thousands of people with brain injuries. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

LET’S GET STARTED

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Defining ADHD in Light of Brain Injuries

How Do You Know If You Have A Concussion?

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How Do You Know If You Have A Concussion?

concussion - what a neuropsychologist can do for you? brain injury

The dreaded “C-word” is thrown around in everyday life, most notably in sports. However, many can be left unsure if they have a concussion, or mild traumatic brain injury (mTBI). Often, there are often no physical signs during a concussion. The most important thing to understand about a concussion is that it is a brain injury and, as a consequence, must be caused by direct or indirect impact on the brain. Brain injury caused by factors other than impact, such as an infection or blood supply to brain, are not concussions.

Well, then how do you know if you have a concussion? All concussions involve a traumatic impact to the head accompanied  by either loss of consciousness (LOC), alteration of consciousness,post traumatic amnesia or focal neurological signs. These are telltale signs that you should be concerned about the prospect of a concussion. However, an important rule of thumb is to seriously consider the possibility of a concussion anytime impact to the head is involved. As stated previously, a concussion is caused by physical injury to the brain. Note that impact can caused by collision between the brain and the skull, which is possible during periods of rapid acceleration changes (such as car accidents). When evaluating for signs of concussion, keep in mind that not all concussions are the same. Therefore, a two people with concussions may experience completely different symptoms. Moreover, the length, onset, and severity of symptoms is rarely, if ever, the same. Since some of the symptoms of a concussion can present weeks after the initial impact, it is important to continue to monitor symptoms beyond the immediate aftermath of an injury.

Often, children and adults will complain about “not feeling themselves.” The following are additional common symptoms of a concussion:

*Persistent headaches

*Difficulty or slowness in remembering, concentrating, making decisions, thinking, speaking, acting, or reading

*Confusion

*Low energy

*Fluctuations in mood

*Disrupted sleep patterns

*Light-headedness, dizziness, or loss of balance

*Nausea

*Sensitivity to lights, sounds, or distractions

*Compromised vision, smell, or taste

*Ringing in the ears

If you or loved one are suspicious of having a concussion, make an appointment for professional evaluation right away. This will help avoid further damage. For employees and athletes, professional guidance is crucial to “return to the field.”

The Pathways team of professionals has helped thousands of people with brain injuries. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

LET’S GET STARTED

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Source: Pathways Neuropsychology
How Do You Know If You Have A Concussion?

Fatigue and Insomnia Following Traumatic Brain Injury (and what you can do to help!)

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Fatigue and Insomnia Following Traumatic Brain Injury (and what you can do to help!)

Traumatic Brain Injury Rehabilitation

Sleep and daytime energy are two crucial aspects to a happy and successful life. That is why it can be very unsettling to traumatic brain injury (TBI) patients to struggle falling asleep, and consequentially, thrive during the daytime. A disruption in the chemical balance in the brain can leave one with a chronic condition of sleepiness and, frustratingly, the inability to maintain a consistent sleep schedule. If this is what you are experiencing, you are not alone. Up to 70% of individuals with TBI will suffer from sleeping problems, even after minor injuries. Lack of sustained quality sleep can be serious, leading to or worsening symptoms of anxiety, depression, and/or physical pain.

Insomnia can possibly appear directly after brain injury and possible persist for years after. During this time, personal relationships, family life, and school/work success can be compromised by sleep-related symptoms. The two most common types of interventions for those with TBI-related insomnia are behavioral modifications and medication. Each case of TBI is different— Pathways emphasized comprehensive evaluations to assemble an individual treatment plan. While it is important to seek professional help for TBIs, here are some general suggestions for those suffering from insomnia:

*Stay consistent! Go to bed and wake up at consistent time (7-9 hours for adults is ideal)

*Avoid caffeine, alcohol and nicotine! These substances disrupt sleep substantially.

*Minimize distractions such as computer, smartphones, television and lights. 

*Exercise regularly. In addition to its anti-depressant effects, exercise can restore chemical balance in brain and get one on a reliable sleep schedule.

*Keep day-time activities out of the bed. Try keeping television and iPhone away when trying to go to sleep. If you cannot fall asleep, use electronics outside of the bed.

The Pathways team of professionals has helped thousands of people with brain injuries. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

LET’S GET STARTED

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Source: Pathways Neuropsychology
Fatigue and Insomnia Following Traumatic Brain Injury (and what you can do to help!)

Parenting a Child With ADHD

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Parenting a Child With ADHD

adhd evaluation

Do: Educate Yourself About ADHD 

A great (and immensely important!) starting point for a parent is understanding what ADHD is and what it means to you and your child.  It is important to realize that the behavior of a child with ADHD is a result of a developmental disorder that affects executive functions. He or she cannot just “snap out of it”.

While professional help is very important, here are some good starting books to help you start your education about ADD/ADHD:

“Smart but Stuck: Emotions in Teens and Adults with ADHD” by Thomas E. Brown, PhD

“New ADHD Medication Rules” by Charlers Parker, MD

“ADHD: What Every Parent Needs to Know” by Michael I. Reiff, M.D.

“Nowhere to Hide: Why Kids with ADHD and LD Hate School and What We Can Do About It” by Jerome J. Schultz, Ph.D

“Driven to Distraction” by Ned Hallowell, MD and John Ratey, MD

Dont: be a downer

Being negative can make one lose perspective and overshadow the positives. Tomorrow is always a new day.

Do: be your child’s advocate

It can be tough for a child to realize that he or she may not be meeting expectations.

Your child needs a proud supporter, one who nourishes and sports the uniqueness and talents. Believe in your child and fight for your child’s success, whether it is talking to school administrators or tutor.

Dont: be militant and take everything personally

Most children will protest and talk back to their parents. While strict limits and discipline must be employed, too harsh of an effort to mute your child can be damaging. This can suppress the spirit and will of a vibrant child. Make sure to set reasonable limits when it comes to disciplining behavior and focus much more on positive attention and positive reinforcement.

Do: trust your child to make choices

Provide opportunities for your child to make choices. This will provide a sense of independence while teaching the value of decisions and consequences. For instance, you can ask your child “would you rather start your HW now or practice your guitar first?”

Don’t: lose control over relationship with child and stay calm

While a child with ADHD may act disorderly, a parent must never lose their grip and authority. Do not be intimidated just because you may feel overwhelmed or frustrated. Patience can be a virtue, but it is ultimately up to the parent to make the rules for acceptable behavior. Try to be accommodating and flexible but make sure to set personal parenting limits of what is “crossing the line.”

Do: Promote Patience

Having ADHD can be very frustrating. Make sure your child understands that success is gradual. Help set incremental goals such as “high marks on the next three English tests” before jumping to grander goals. Over time, the bar can be set increasingly higher.

In addition, set up an organized household with limited distractions. It is beneficial to have a quiet space that is neat and free of messes and distractions such as television and video games. This organization will set good example and reduce any additional burdens a student with ADHD may encounter with unnecessary disorder.

Don’t: Try to fix everything at once 

Parenting a child with ADHD is a marathon, not a sprint. Personal time for yourself can be extremely beneficial in preventing “burnout.” Relax. Go to the gym. Go on a walk. Get proper sleep. The better mindset you are in, the better job you will do parenting. Be confident in yourself and in your child. Positive change will come with gradual persistence.

Do: focus on the basics and set rewards!

Exercise, sleep, and a healthy diet are key ingredients for improved behavior. Poor sleep, poor nutrition, and insufficient exercise can make ADHD symptoms worse. Recreational sports, family hikes, and routine bedtimes are all good ideas. Set a good example!

In addition, make sure your child is rewarded for positive steps in right direction. Children with ADHD are highly sensitive to cognitive reward responses. Positive feedback can reinforce good behavior. For instance, you can make a marble jar that is filled with a marble for each high test mark, positive teacher review, etc. Once the jar is filled, you can reward your child with an agreed upon prize.

Do: seek expert help

Dr. Gordon is an experienced ADHD expert. He is devoted to helping you learn more about ADHD and find solutions for each individual’s need!

The Pathways team of professionals has helped thousands of people with brain injuries. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

LET’S GET STARTED

The post Parenting a Child With ADHD appeared first on Pathways Neuropsychology Associates.


Source: Pathways Neuropsychology
Parenting a Child With ADHD

Parenting a Child With ADHD

/0 Comments/in /by

Parenting a Child With ADHD

adhd evaluation

Do: Educate Yourself About ADHD 

A great (and immensely important!) starting point for a parent is understanding what ADHD is and what it means to you and your child.  It is important to realize that the behavior of a child with ADHD is a result of a developmental disorder that affects executive functions. He or she cannot just “snap out of it”.

While professional help is very important, here are some good starting books to help you start your education about ADD/ADHD:

“Smart but Stuck: Emotions in Teens and Adults with ADHD” by Thomas E. Brown, PhD

“New ADHD Medication Rules” by Charlers Parker, MD

“ADHD: What Every Parent Needs to Know” by Michael I. Reiff, M.D.

“Nowhere to Hide: Why Kids with ADHD and LD Hate School and What We Can Do About It” by Jerome J. Schultz, Ph.D

“Driven to Distraction” by Ned Hallowell, MD and John Ratey, MD

Dont: be a downer

Being negative can make one lose perspective and overshadow the positives. Tomorrow is always a new day.

Do: be your child’s advocate

It can be tough for a child to realize that he or she may not be meeting expectations.

Your child needs a proud supporter, one who nourishes and sports the uniqueness and talents. Believe in your child and fight for your child’s success, whether it is talking to school administrators or tutor.

Dont: be militant and take everything personally

Most children will protest and talk back to their parents. While strict limits and discipline must be employed, too harsh of an effort to mute your child can be damaging. This can suppress the spirit and will of a vibrant child. Make sure to set reasonable limits when it comes to disciplining behavior and focus much more on positive attention and positive reinforcement.

Do: trust your child to make choices

Provide opportunities for your child to make choices. This will provide a sense of independence while teaching the value of decisions and consequences. For instance, you can ask your child “would you rather start your HW now or practice your guitar first?”

Don’t: lose control over relationship with child and stay calm

While a child with ADHD may act disorderly, a parent must never lose their grip and authority. Do not be intimidated just because you may feel overwhelmed or frustrated. Patience can be a virtue, but it is ultimately up to the parent to make the rules for acceptable behavior. Try to be accommodating and flexible but make sure to set personal parenting limits of what is “crossing the line.”

Do: Promote Patience

Having ADHD can be very frustrating. Make sure your child understands that success is gradual. Help set incremental goals such as “high marks on the next three English tests” before jumping to grander goals. Over time, the bar can be set increasingly higher.

In addition, set up an organized household with limited distractions. It is beneficial to have a quiet space that is neat and free of messes and distractions such as television and video games. This organization will set good example and reduce any additional burdens a student with ADHD may encounter with unnecessary disorder.

Don’t: Try to fix everything at once 

Parenting a child with ADHD is a marathon, not a sprint. Personal time for yourself can be extremely beneficial in preventing “burnout.” Relax. Go to the gym. Go on a walk. Get proper sleep. The better mindset you are in, the better job you will do parenting. Be confident in yourself and in your child. Positive change will come with gradual persistence.

Do: focus on the basics and set rewards!

Exercise, sleep, and a healthy diet are key ingredients for improved behavior. Poor sleep, poor nutrition, and insufficient exercise can make ADHD symptoms worse. Recreational sports, family hikes, and routine bedtimes are all good ideas. Set a good example!

In addition, make sure your child is rewarded for positive steps in right direction. Children with ADHD are highly sensitive to cognitive reward responses. Positive feedback can reinforce good behavior. For instance, you can make a marble jar that is filled with a marble for each high test mark, positive teacher review, etc. Once the jar is filled, you can reward your child with an agreed upon prize.

Do: seek expert help

Dr. Gordon is an experienced ADHD expert. He is devoted to helping you learn more about ADHD and find solutions for each individual’s need!

The Pathways team of professionals has helped thousands of people with brain injuries. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

LET’S GET STARTED

The post Parenting a Child With ADHD appeared first on Pathways Neuropsychology Associates.


Source: Pathways Neuropsychology
Parenting a Child With ADHD

Brain Injury Awareness

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Brain Injury Awareness

brain injury, traumatic brain injury, tai, concussionsMarch is Brain Injury Awareness Month. As the month comes to a close, it is important to discuss what causes– and what happens during– a traumatic brain injury (TBI). After all, TBI’s effects over 2.5 million individuals in the United States.

What is a TBI?

Simply, a TBI is a physical injury to the brain. However, the injury comes from a physical outside impact or the brain’s impact with the skull. A TBI does not refer to hypoxia (lack of oxygen to brain), stroke, or tumor. Instead, the major causes of TBI are falls (28%), car crashes (20%), and blunt force from an object (19%). After initial assault, further damage could be done in what is known as a secondary injury. An example of a secondary injury is restricted blood flow to a region of the brain.

“I am confused. Do I have a concussion or a TBI?”

The short answer is: most likely both! That is because a concussion, by definition, is a type of brain injury often referred to a mild TBI (mTBI). A concussion is therefore a type of brain injury that, depending on the severity, can be quite serious. Sports players are especially vulnerable due to physical contact with the skull. If you are experiencing headaches, fatigue, and/or poor balance, it is wise to make a consultation before continuing intense physical exercise. To learn more about concussions, check out the Pathways website!

What happens to your brain during a TBI?

The human brain is an astonishing organ, weighing in at roughly over  three pounds  and consisting of 86 billion neurons (brain cells). The texture of the brain can be best compared to that of gelatin. The skull is a hard protective barrier between the delicate brain tissue and the environment. However, when the brain is injured, it swells and fills with fluid just as other parts of the body would. Swelling can cause your brain to push against the skull, causing immense pressure inside the head that could potentially cause further damage, discomfort, and pain.

The neurons of the brain communicate via special messenger molecules called neurotransmitters. These chemicals are in proper balance in order to control mood, sleep, desire, and sense of happiness. A TBI will often disturb this delicate chemistry, resulting in altered emotions and thoughts. Consequently, behavior is often disturbed in those with TBIs.The brain’s chemical balance will often restore itself upon healing. When the injury is very severe, sometimes medications are warranted to intervene in brain’s chemical makeup.

“I am not sure if I have a TBI. What should I do?!”

Professional medical attention is crucial if you are suspicious that you may have a brain injury. Through comprehensive evaluations and sophisticated brain imaging, you can work together with your doctor to heal and prevent further injury.

Check out Dr. Sanjay Gupta of CNN discuss TBIs:

The Pathways team of professionals has helped thousands of people with brain injuries. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

LET’S GET STARTED

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Source: Pathways Neuropsychology
Brain Injury Awareness

Sex Life and Emotional Wellness after Traumatic Brain Injury

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Sex Life and Emotional Wellness after Traumatic Brain Injury

traumatic brain injury -tbi and sex

For both male and female adults recovering from traumatic brain injuries (TBI), self-confidence and sexual enjoyment can be compromised on the road to recovery. Sexual difficulties are not trivial, as they can lead to low self-esteem and significant relationship problems. Decreased sex drive, decreased arousal, erectile dysfunction, inability to achieve orgasm, and/or hypersexuality are common experiences after TBI.

Neurotransmitters are the messengers between brain cells and are vital for cognitive function and emotional well being. Neurotransmitters are also responsible for feelings of intimacy and sexual arousal. Moreover, they message the body to send blood to sexual organs. Therefore, assaults to the brain that affect its chemical makeup may have significant implications for one’s physical satisfaction and intimate relationships.

Every TBI case is different and, depending on the primary injury and consequent manifestation of the disease, the extent and nature of sexual wellness in each patient will vary. It is our goal at Pathways to tailor treatment and therapy options in a personalized manner. 

Sexual dysfunction after TBI can result from a primary direct assault to the brain or a secondary cause downstream of the initial impact. The location of the brain that has been insulted will dictate the type of sexual problems one may encounter. Even within a region of a brain, specific subregions entail different functions. For instance, within the frontal lobe of the brain, damage to the dorsolateral frontal lobe typically leads to a reduced sex drive while damage to the orbitofrontal region may lead to hypersexuality. When damage impairs neurochemical/neuroendrocrine functions of the brain, a secondary cause of compromised sexual function can result from the impairment of blood hormone levels. Medications, another secondary source of sexual impairment, such as anticonvulsants, antidepressants, anticholinergics, and serotonergic agonists can reduce sex drive, among other side effects.  Anxiety and depression, often coinciding with TBI can also interfere with sexual functioning and desire.

At Pathways, we are here to make an environment of comfort and openness regarding sexuality concerns. Mental well-being and sexual health is incorporated into our comprehensive evaluation and treatment of TBIs.

The Pathways team of professionals has helped thousands of people with brain injuries. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

LET’S GET STARTED

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Source: Pathways Neuropsychology
Sex Life and Emotional Wellness after Traumatic Brain Injury

Military Study: Aerobic Exercise as an Effective Treatment for mTBI

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Military Study: Aerobic Exercise as an Effective Treatment for mTBI

military TBI brain injuries led

David K Johnson, PhD and the Department of Defense have teamed up to investigate the healing effects of aerobic exercise on mild traumatic brain injuries (mTBI). The researchers are focusing on United States soldiers who have experienced brain injuries from improvised explosive devices, or IEDs, in Iraq and Aphganistan. While rarely resulting in penetrating harm, IEDs are a common tool of terrorist organizations and their detonation can result in severe head trauma followed by up to six minutes of loss consciousness. Johnson’s results, which show beneficial improvements to soldiers’ conditions upon significant exercise, may have broad implications to those diagnosed with mTBI that are fit enough for aerobic exercise.

Although a specialist on Alzheimers, Johnson appreciates the possible overlaps with mTBIs in younger patients when it comes to the biochemical processes in the brain. When talking about his study, which was spearheaded by a $500,000 grant to improve the life quality of US soldiers, Johnson explains that, “An awful lot of the biochemical process in mTBI appears to be related to Alzheimer’s disease […] we know aerobic exercise can reduce the amount of biochemicals associated with Alzheimer’s disease, reduce the plaques and tangles, so we think it will work with mTBI as well. Aerobic exercise helps the brain heal itself.” To further test this hypothesis, Johnson is working with one hundred volunteers at Fort Riley to test for cognitive fitness before and after structured aerobic training.

mTBI is the most common brain injury. Athletic activity and warfare dramatically increase the chance of mTBI, most often due to non-penetrating impact on the brain. The good news is, however, that young athletes, soldiers, and veterans that have mTBI can still partake in aerobic exercise unless physically barred from running. Johnson and his team are hopeful and eager about their study. Moreover, by looking for physical and chemical signatures, more can be understood about prolonged brain injuries. “Because mTBI shares so much biologically with early Alzheimer’s disease,” Johnson explain, “I hope that what is working in our older adults also works in these young men and women.”

SOURCE: 

https://news.ku.edu/2016/12/06/researchers-use-aerobic-exercise-promising-treatment-wounded-warriors-mild-traumatic

The Pathways team of professionals has helped thousands of people with brain injuries. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

LET’S GET STARTED

The post Military Study: Aerobic Exercise as an Effective Treatment for mTBI appeared first on Pathways Neuropsychology Associates.


Source: Pathways Neuropsychology
Military Study: Aerobic Exercise as an Effective Treatment for mTBI