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

Chin, Lisa M. K. PhD; Chan, Leighton MD, MPH; Woolstenhulme, Joshua G. DPT; Christensen, Eric J. MS; Shenouda, Christian N. MD; Keyser, Randall E. PhD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP; Brenner, Lisa PhD, ABPP

The Journal of Head Trauma Rehabilitation: November/December 2015 - Volume 30 - Issue 6 - p 382–390
doi: 10.1097/HTR.0000000000000062
Original Articles

Objective: To examine cardiorespiratory fitness in individuals with traumatic brain injury (TBI), before and following participation in a supervised 12-week aerobic exercise training program.

Methods: Ten subjects with nonpenetrating TBI (TBI severity: mild, 50%; moderate, 40%; severe, 10%; time since injury [mean ± SD]: 6.6 ± 6.8 years) performed exercise training on a treadmill 3 times a week for 30 minutes at vigorous intensity (70%-80% of heart rate reserve). All subjects completed a cardiopulmonary exercise test, with pulmonary gas exchange measured and a questionnaire related to fatigue (Fatigue Severity Scale) at baseline and following exercise training.

Results: After training, increases (P < .01) in peak oxygen consumption (



; +3.1 ± 2.4 mL/min/kg), time to volitional fatigue (+1.4 ± 0.8 minutes), and peak work rate (+59 ± 43 W) were observed. At the anaerobic threshold,



(+3.6 ± 2.1 mL/kg/min), treadmill time (+1.8 ± 1.1 minutes), and work rate (+37 ± 39 W) were higher (P < .01) following exercise training. Subjects also reported significantly lower (P < .05) Fatigue Severity Scale composite scores (−0.9 ± 1.3) following exercise training.

Conclusion: These findings suggest that individuals with TBI may benefit from participation in vigorous aerobic exercise training with improved cardiorespiratory fitness and diminished fatigue.

Department of Rehabilitation Science, George Mason University, Fairfax, Virginia (Drs Chin, Woolstenhulme, and Keyser); and Rehabilitation Medicine Department, National Institutes of Health Clinical Center (Drs Chin, Chan, Woolstenhulme, and Keyser and Mr Christensen), and Center for Neuroscience and Regenerative Medicine (Drs Chan and Shenouda), Bethesda, Maryland.

Corresponding Author: Lisa M. K. Chin, PhD, Department of Rehabilitation Science, George Mason University, 4400 University Dr, Fairfax, VA 22030 (

This study was supported by the Center for Neuroscience and Regenerative Medicine (G192HI-H) and the National Institutes of Health Clinical Center (Rehabilitation Medicine Department Intramural Funds). The authors thank Bart Drinkard and Anne Quinn for their assistance with the exercise training sessions and data collection. They also thank Beth Kvochak for initial recruitment efforts.

The authors declare no conflicts of interest.

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