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Endurance Training and Cardiorespiratory Conditioning After Traumatic Brain Injury

Mossberg, Kurt A. PT, PhD; Amonette, William E. MA; Masel, Brent E. MD

Section Editor(s): McCulloch, Karen L. PT, PhD, NCS

Journal of Head Trauma Rehabilitation: May-June 2010 - Volume 25 - Issue 3 - p 173–183
doi: 10.1097/HTR.0b013e3181dc98ff

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% to 30% compared with 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. Long-term follow-up studies are needed to assess the effectiveness of cardiorespiratory training programs on overall morbidity and mortality.

University of Texas Medical Branch, Galveston (Dr Mossberg and Mr Amonette); and Transitional Learning Center, Galveston, Texas (Dr Masel).

Corresponding author: Kurt A. Mossberg, PT, PhD, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555 (

This work was partially supported by the National Institutes of Health R01 HD046570 to Dr Mossberg and T32 HD007539 to Mr Amonette. The authors thank Paula Skinkis for editorial assistance.

© 2010 Lippincott Williams & Wilkins, Inc.