Endurance Training and Cardiorespiratory Conditioning After Traumatic Brain Injury

Abstract

Objective-To examine the importance of cardiorespiratory conditioning after traumatic brain injury (TBI) and provide recommendations for patients recovering from TBI.Method-Review of literature assessing the effectiveness of endurance training programs.Main outcomes and results-A sedentary lifestyle and lack of endurance are common characteristics of individuals with TBI who have a reduction in peak aerobic capacity of 25-30% compared to healthy sedentary persons. Increased physical activity and exercise training improves cardiorespiratory fitness in many populations with physical and cognitive impairments. Therefore, increasing the endurance and cardiorespiratory fitness of persons with TBI would seem to have important health implications. However, review of the TBI literature reveals that there have been few well-designed, well-controlled studies of physiologic and psychological adaptations of fitness training. Also lacking are long-term follow-up studies of persons with TBI.Conclusions-Assessing endurance capacity and cardiorespiratory fitness early in the TBI rehabilitation process merits consideration as a standard of care by professional rehabilitation societies. Also, providing effective, safe and accessible training modalities would seem to be an important consideration for persons with TBI, given the mobility impairments many possess. Longterm follow-up studies are needed to assess the effectiveness of cardiorespiratory training programs on overall morbidity and mortality.

Improved Cardiorespiratory Fitness With Aerobic Exercise Training in Individuals With Traumatic Brain Injury

“…56 Differences in exercise training methods and outcome variables make direct comparisons of these studies with the present study somewhat difficult. Several studies inferred cardiorespiratory fitness from changes in work rate during a peak 33 or sub-maximal 35,36 exercise test.…”

“…Compared to the present study, this was 42 – 45% less exercise time performed at a lighter intensity over the same time period. These studies suggest that improvements in cardiorespiratory fitness are possible in individuals with TBI when exercise is of sufficient intensity and duration 56 to induce an aerobic effect. Results of the current study suggest that exercise of higher intensity may be more effective for improving cardiorespiratory fitness in individuals with TBI, particularly when sustained at the intended target heart rate range for a given period of time.…”

Monitoring changes in heart rate, as an indicator of the cardiovascular autonomic nervous function, among patients at the sub-acute phase post-brain damage during a physiotherapy session: A preliminary investigation

“…The complex reaction of patients post-brain injury to training has been described before; Mossberg et al [19] assessed 40 patients in the post-acute phase post-TBI who received 1 hour of physical therapy 3-times a week, including individualized training of gross motor skills, flexibility, strength and endurance. It was noted that VO 2 at any given workload was lower after the therapy intervention, suggesting improved movement efficiency.…”

Pediatric cardio-autonomic response to variable effort after severe traumatic brain injury

“…It has been noted that children post-severe (TBI) have a low tolerance for physical activity when compared with healthy peers [1]. This low tolerance is often explained by the impaired motor abilities post-injury or by the secondary physical conditions, such as soft tissue contractures or sedentary behaviour postinjury [2].…”