Can brain-injured patients participate in an aerobic exercise programme during early inpatient rehabilitation?

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Abstract
Objective: We investigated the capacity of brain-injured patients to participate in an aerobic exercise programme early after injury. Design: Retrospective analysis of exercise achievements in patients participating in a randomized controlled trial. Setting and subjects: Ninety patients participated in an exercise training programme on a cycle ergometer at four inpatient neurological rehabilitation units for younger patients. At intake, impairments and function were rated on: Motricity Index, Ashworth Scale, Berg Balance Scale, Barthel Index and Functional Independence Measure. Interventions: Patients cycled for up to 30 minutes three times weekly for 24–36 sessions over 12 weeks. Main outcome measures: Exercise performance was measured by: (a) number of sessions to achieve a cycling time of 30 minutes, (b) overall mean cycling time per session over 24 sessions and (c) mean time per session cycling at >60% of age predicted maximum heart rate (HR max) over 24 sessions. Results: Fifty-five patients completed 24 sessions. Thirty-five withdrew, largely for logistic reasons, before completing training; they were significantly less disabled than the 55 who remained. Forty-four of the 55 patients trained for an average of at least 20 minutes per session, 18 training at >60% HR max for this time. There were no differences in performance on the three exercise parameters between two groups of patients with baseline Barthel scores of ≤12 and ≥13. Conclusions: Brain-injured patients with a range of disabilities have the capacity to participate in an exercise programme during early inpatient rehabilitation, though some may take longer to achieve adequate intensity of aerobic exercise.