Shining a light on recovery : investigating the effectiveness of bright light therapy in mitigating fatigue after mild traumatic brain injury : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, New Zealand
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Date
2023
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Massey University
Figure 1 (=North et al., 2012 Fig 1) was removed for copyright reasons. Figure 2 is reused under a Creative Commons Attribution 4.0 International (CC-BY 4.0) license.
Figure 1 (=North et al., 2012 Fig 1) was removed for copyright reasons. Figure 2 is reused under a Creative Commons Attribution 4.0 International (CC-BY 4.0) license.
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Abstract
Fatigue is a common and debilitating symptom experienced by individuals following a mild traumatic brain injury (mTBI). Despite its prevalence, post-mTBI fatigue remains a challenging, and at times misunderstood condition, with a scarcity of scientifically evidenced treatment approaches. The complexity of fatigue's underlying causes in this population calls for further research. Recognising its significant impact on individuals' quality of life emphasises the need to identify effective interventions and enhance symptom management.
This study aims to investigate the potential effectiveness of daily bright light exposure as a non-invasive intervention to alleviate fatigue in the post-mTBI population. While existing research has shown positive outcomes for bright light therapy in managing fatigue in broader traumatic brain injury populations, the current study focuses on individuals with injuries at the mild end of the spectrum, offering valuable insights into the efficacy of this treatment in a more targeted context.
The primary objective of the research was to investigate whether daily bright light exposure effectively reduced fatigue symptoms in individuals with mTBI. Additionally, the study aimed to explore the impact of light exposure on secondary outcomes, including daytime sleepiness, sleep quality, depression, anxiety, stress, and circadian rest-activity cycles. To address recruitment challenges, a randomised multiple baseline controlled trial design was adopted.
The results revealed that all nine participants consistently experienced significant fatigue throughout the study. Fatigue levels appeared to decrease during the bright light therapy sessions suggesting a potential positive impact of bright light exposure on fatigue, although this reduction was not statistically significant across the group.
Due to limitations in data, the ability to confidently demonstrate efficacy was low and this prompted a shift in focus towards assessing the feasibility of conducting research of this nature. Moving forward, future studies can benefit from an understanding of the complexities involved in implementing intensive intervention protocols. The current study demonstrates a need for close collaboration with participants to monitor adherence and potential side effects, alongside coordination with colleagues in the mTBI field to ensure access to a sufficient participant pool for achieving statistically significant results.
Overall, this research provides some limited evidence of positive effects from bright light therapy for select individuals and contributes to the expanding body of evidence investigating light as a potential intervention for alleviating fatigue symptoms post-mTBI. More importantly, by shedding light on the hurdles in implementing such interventions among individuals with mTBI, it contributes to the development of targeted and potentially effective interventions for improving the quality of life for individuals affected by this condition. It is hoped that this study contributes to the broader literature aimed at facilitating better outcomes for individuals with mTBI and related fatigue symptoms.
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Keywords
Brain, Wounds and injuries, Treatment, Light, Therapeutic use, Physiological effect, Fatigue, Prevention, mild traumatic brain injury (mTBI), bright light therapy