Pilot study of intensive exercise on endurance, advanced mobility and gait speed in adults with chronic severe acquired brain injury

Abstract

Background and purpose: Effects of high-intensity exercise on endurance, mobility and gait speed of adults with chronic moderate-to-severe acquired brain injury (ABI) were investigated. It was hypothesized that intensive exercise would be associated with improvements in impairment and activity limitation measures.

Participants: Fourteen adults with chronic ABI in supported independent living who could stand with minimal or no assist and walk with or without ambulation device were studied. Eight presented with low ambulatory status.

Methods: This was a single group pre- and post-intervention study. Participants received a 6-week exercise intervention for 60–90 minutes, 3 days/week assisted by personal trainers under physical therapist supervision. Measures (6MWT, HiMAT and 10MWT) were collected at baseline, post-intervention and 6 weeks later. Repeated measures T-test and Wilcoxon Signed Ranks test were used.

Results: Post-intervention improvements were achieved on average on all three measures, greater than minimal detectable change (MDC) for this population. Three participants transitioned from low-to-high ambulatory status and maintained the change 6 weeks later.

Discussion and conclusion: People with chronic ABI can improve endurance, demonstrate the ability to do advanced gait and improve ambulatory status with 6 weeks of intensive exercise. Challenges to sustainability of exercise programmes for this population remain.

Keywords:

• Activity
• community integration
• functional status
• stroke
• traumatic brain injury

Acknowledgements

The authors would like to thank the research participants and express appreciation for support from Supportive Living Inc. (SLI) staff, Advocates staff, and AccesSportAmerica trainers for this study. We would also like to acknowledge funding support for the study and for ongoing exercise programming at the SLI Brain Injury Wellness Center from the Massachusetts Rehabilitation Commission as well as in-kind donations from AccesSportAmerica. We also express appreciation to members of the SLI Research Council for their review and discussion of the study design, data and this paper. The authors also thank the peer reviewers, whose careful review was much appreciated.

Declaration of interest

This study was performed at the Supportive Living Inc. Wellness Center in Lexington, MA with IRB approval from MCPHS University. Preliminary study results were presented (oral presentation) at the 33^rd Annual Conference of Brain Injury Association of Massachusetts in March 2014. Revised study results were presented (poster) at the American Congress of Rehabilitation Medicine, 92^nd Annual Conference, Progress in Rehabilitation Research, October 2015. This study received support for exercise professionals from the Massachusetts Rehabilitation Commission and an in-kind donation from AccesSportAmerica. The authors report no conflicts of interest.