Feasibility of Aerobic Exercise in the Subacute Phase of Recovery From Traumatic Brain Injury: A Case Series.
Timothy P Morris, David Costa-Miserachs, Pablo Rodriguez-Rajo and 5 others
PMID 30138231WHAT IT FOUND
Five patients with moderate-to-severe brain injury tolerated adding aerobic exercise to their rehabilitation.
They attended sessions consistently, but most failed to reach the target heart rate zone, and self-reported effort did not match heart rate data.
Key findings
01Participants adhered to the exercise program with no serious adverse events.
02Only two of the five participants spent more than half their exercise time within the target heart rate zone.
03There was a low correlation between perceived exertion and heart rate reserve across all participants.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a case series of only five people, so it cannot determine if the exercise caused any improvements in function or cognition. The participants were all male and had varying concomitant injuries, limiting how widely these findings apply. The study used a wrist-based heart rate monitor, which may be less accurate than chest straps due to motion artifact. Resting heart rate was not re-measured before each session, so changes in training zones over the 8 weeks were not accounted for. The Borg scale of perceived exertion has not been validated in people with traumatic brain injury, and some participants showed poor awareness of their own fatigue.
Declared interests
The paper acknowledges support from the National Institutes of Health and other non-U.S. government sources. It does not report any commercial conflicts of interest or industry funding.
The easy way to misread this
Do not interpret the high adherence rates as evidence that the exercise program was effective for cognitive or physical recovery. The study was designed only to test if the program could be done safely and consistently, not to measure if it helped patients get better. Additionally, the failure to reach target heart rates suggests that standard intensity calculations may be inappropriate for this population.