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Cardiorespiratory Capacity After Weight-Supported Treadmill Training in Patients With Traumatic Brain Injury

KA Mossberg, PT, PhD, is Professor, Department of Physical Therapy, School of Allied Health Sciences, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1144 (USA).
EE Orlander, PT, MPT, is Research Assistant, Department of Physical Therapy, School of Allied Health Sciences, University of Texas Medical Branch.
JL Norcross, BS, is Research Assistant, Department of Physical Therapy, School of Allied Health Sciences, University of Texas Medical Branch.

kmossber{at}utmb.edu

Background and Purpose: The primary goal of body-weight–supported treadmill training (BWSTT) has been to improve the temporal and spatial characteristics of unsupported overground walking; however, little attention has been given to cardiorespiratory adaptations. The purpose of this case report is to describe the effects of BWSTT on cardiorespiratory fitness in 2 patients recovering from severe traumatic brain injury (TBI).

Case Description: Both patients were involved in motor vehicle accidents and were studied after admission to a postacute residential treatment program. Patient 1 was a 25-year-old man (initial Glasgow Coma Scale [GCS] score=3) who began observation and treatment 3 months after the injury. Patient 2 was an 18-year-old woman (initial GCS=6) who began observation and treatment 1 year after the injury.

Outcomes: Each patient received 2 to 3 sessions of BWSTT per week. Aerobic capacity was measured while they ambulated on a treadmill without body-weight support before and after BWSTT. Both patients' submaximal and peak responses improved. For patient 1 and patient 2, total treadmill work performed increased 134% and 53%, respectively. Peak oxygen uptake increased 24% for patient 1 and 16% for patient 2. Estimated cardiac stroke volume (oxygen pulse) increased 32% and 26% for patient 1 and patient 2, respectively.

Discussion: The observations made on these 2 patients suggest that BWSTT has the potential to favorably change cardiorespiratory capacity after TBI.