OBJECTIVE: To evaluate the effects of a 12-week digital walking exercise program on functional capacity and psychological health in individuals with mild traumatic brain injury (mTBI) and examine the influence of exercise adherence. DESIGN: Randomized controlled trial with repeated measures. SETTING: Medical center-based recruitment with home-based intervention. PARTICIPANTS: Fifty-two adults (mean age 43.98 +/- 14.94, 57.7% female) diagnosed with mTBI (Glasgow Coma Scale score, 13 to 15) within 6 months post-injury. INTERVENTIONS: Participants were randomly assigned to either a digitally monitored walking program group (structured walking >= 30 min/session, >= 3 times/week, supported by a wearable fitness tracker and personalized feedback) or an active control group receiving standard exercise education. MAIN OUTCOME MEASURES: Primary outcome was functional capacity measured by the 6-minute walk test (6MWT). Secondary outcomes included depressive symptoms (Beck Depression Inventory-II) and quality of life (QoL; WHOQOL-BREF). Assessments were conducted at baseline, 4, 8, and 12 weeks. Generalized estimating equations assessed between-group differences. Subgroup analyses evaluated outcomes in participants with >= 80% adherence to moderate-intensity exercise. RESULTS: The intervention group demonstrated significantly greater improvements in 6MWT distance at 4 weeks (+41.65 m, p = 0.02), 8 weeks (+61.31 m, p = 0.001), and 12 weeks (+65.29 m, p = 0.003) compared to controls. Between-group differences in depressive symptoms and psychological QoL were not statistically significant. However, in the high-adherence subgroup (>= 80%), significant improvements were observed in functional capacity, as measured by the 6-Minute Walk Test (6MWT), as well as in depressive symptoms, and overall QoL. CONCLUSIONS: A 12-week digital walking program significantly improved functional capacity in individuals with mTBI. Psychological health benefits were evident among those with high adherence to moderate-intensity walking. These findings support integrating wearable technologies and remote monitoring tools into structured rehabilitation to promote functional recovery in mTBI.

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