Purpose: The primary aim of this study was to investigate whether a circuit class can provide sufficient exercise dosage to induce a cardiorespiratory fitness training effect (>50% heart rate reserve [HRR] for 20mins or caloric expenditure of 300 kilocalories [kcal]) in adults with traumatic brain injury (TBI). The secondary aim investigated whether heart rate monitors can influence the intensity of exercise. Relevance: TBI is the leading cause of long-term disability in young adults. People after TBI are very deconditioned, and therefore fitness training needs to be incorporated in rehabilitation. A circuit training style of rehabilitation delivery has been shown to be effective at improving gait parameters. Due to the long duration and large muscle group type of exercises prescribed in a circuit class, it has the potential to provide a fitness training effect. Participants: Forty four participants were recruited from a metropolitan brain injury rehabilitation unit. Inclusion criteria were: severe TBI; out of posttraumatic amnesia; no behaviour problems unsuitable for a group setting. Participants were predominantly young (mean age = 34 years) males (63%), who had sustained an extremely severe TBI (mean length posttraumatic amnesia = 57 days) from a road traffic accident (61%) on average 4-months before entering the study. Methods: Part 1 was an observational descriptive study within a circuit class run three days per week. The class consists of 10 4-minute exercise stations of strength, fitness and task specific exercises, followed by a walking race. Heart rate monitors were covered and used to record and collect the following data: time spent above 50%HRR, kilocalories burnt, average exercise duration, and average and maximum heart rates. Participants who spent less than 20 minutes above 50%HRR were recruited into part 2 of the study; a randomised controlled trial. Participants were randomly allocated to one of two groups for a 2-week period: the experimental group receiving exercise intensity feedback via visual and audio feedback from a heart rate monitor, and the control group who received no feedback. Analysis: Descriptive statistics were used for exercise data. The primary outcome measure was the time spent above 50%HRR. Student’s t-test was used to compare the experimental group to the control group for the primary outcome measure. Results: Participants spent on average less than 20 minutes above 50% HRR (mean [SD] 14  minutes) but expended >300 kcal (mean [SD] 379  kcal). The mean (SD) duration and intensity of exercise were 52 (3) minutes and 39%HRR respectively. Participants comprehended the audio feedback of the heart rate monitor but did not necessarily increase exercise intensity. Physiotherapists utilised heart rate monitors to know when to encourage exercise intensity. Conclusions: The low intensity long duration structure of a circuit class can provide sufficient exercise dosage for a fitness training effect. To confirm people with TBI can increase fitness from participating in a circuit class requires investigation with a randomised controlled trial. Implications: Long duration fitness training can be prescribed when patients are only able to work at a low intensity. Physiotherapists can use heart rate monitors to ensure sufficient exercise dosage is completed for fitness training benefits.
|Number of pages||1|
|Issue number||Supplement 1|
|Publication status||Published - 2011|
|Event||World Physical Therapy 2011: 16th International WCPT Congress - Amsterdam, Netherlands|
Duration: 20 Jun 2011 → 23 Jun 2011