Ambulatory efficiency in persons with acquired brain injury after a rehabilitation intervention

Abstract

the results suggest an improvement in both aerobic capacity and movement efficiency. Further controlled studies will be necessary to distinguish between cardiorespiratory and neuromuscular adaptations. The changes observed should allow for greater community participation and functional independence after discharge.

Reliability of Graded Exercise Testing after Traumatic Brain Injury

“…This modified protocol has been used previously in individuals recovering from TBI. 6,11 After the 2-min warm-up phase and attainment of the maximal speed, the workload was increased by raising the incline 2% every minute until the test ceased. Subjects were instructed to give their best effort and that there was no set time that they were expected to walk.…”

“…This is an important consideration because patients with TBI have shown measurable fitness improvements at submaximal levels of effort after a rehabilitation intervention. 11 Moreover, the high reliability during submaximal work demonstrated in this study is significant because of the potential safety concerns that accompany maximal testing (balance, pain), and it may provide the data necessary for reliable prediction of maximal aerobic capacity in the patient with disability. 10 Further research in this area is necessary in patients with TBI.…”

“…Submaximal responses are of particular importance in the evaluation of rehabilitation interventions because they are more functionally relevant 10 and can give greater insight into the efficiency of ambulation than peak responses. 11 These tests can be single-stage or multistage in which the individual is not required to exert himself or herself maximally. Submaximal tests are easier to perform and therefore would be more applicable to patients with gait abnormalities or other impairments that would limit their ability to achieve a maximal effort.…”

Endurance Training and Cardiorespiratory Conditioning After Traumatic Brain Injury

“…We strongly recommend that the guidelines outlined in Table 2 be followed as closely as feasible. The results of previous studies in subjects with TBI clearly indicate that significant changes in aerobic capacity and cardiorespiratory fitness will only occur if there is a reasonable approximation of the intensity, frequency and duration guidelines 21, 22, 86, 87, 90, 91…”

“…Routine physical therapy and specific aerobic training can improve submaximal ambulatory efficiency in patients with a brain injury 86. In a study by Mossberg et al, forty patients in the post acute phase of recovery received one hour of physical therapy three times a week, including individualized training of gross motor skills, flexibility, strength, and endurance.…”