title: Circuit class therapy can provide a fitness training stimulus for adults with severe traumatic brain injury: a randomised trial within an observational study.
abstract: OBJECTIVE
  Can circuit class therapy provide sufficient exercise dosage (at least 20 minutes at ≥ 50% heart rate reserve or total caloric expenditure ≥ 300 kilocalories) to induce a cardiorespiratory fitness effect in adults with traumatic brain injury? Can feedback from heart rate monitors influence exercise intensity?
  
  
  METHODS
  Randomised controlled trial within an observational study.
  
  
  METHODS
  Fifty-three people with severe traumatic brain injury, of whom 40 progressed into the trial.
  
  
  METHODS
  All participants undertook circuit class therapy. Participants allocated to the experimental group received exercise intensity feedback from a heart rate monitor and the control group received no feedback.
  
  
  METHODS
  Proportion of participants exercising at ≥ 50% heart rate reserve for at least 20 minutes or expending ≥ 300 kilocalories during circuit class therapy. The primary outcome measure for the trial was the time spent in the heart rate training zone (ie, at ≥ 50% heart rate reserve) during the intervention and re-assessment periods.
  
  
  RESULTS
  Circuit class therapy provided sufficient cardiorespiratory exercise dosage for 28% (95% CI 18 to 42) of the cohort according to the heart rate reserve criteria and 62% (95% CI 49 to 74) according to the caloric criteria. Feedback did not increase the time in the training zone during the intervention (mean difference 4.8 minutes, 95% CI -1.4 to 10.9) or re-assessment (1.9 minutes, -4.4 to 8.3) periods.
  
  
  CONCLUSIONS
  The low intensity, long duration structure of circuit class therapy can provide sufficient exercise dosage for a fitness training effect for 62% of people with traumatic brain injury. Feedback from heart rate monitors does not necessarily influence exercise intensity.
  
  
  BACKGROUND
  ACTRN12607000522415.
authors.affiliation: Liverpool Brain Injury Rehabilitation Unit, South Western Sydney Local Health District, Australia. Leanne.hassett@sswahs.nsw.gov.au
authors.forename: Leanne M
authors.initials: LM
authors.lastname: Hassett
authors.forename: Anne M
authors.initials: AM
authors.lastname: Moseley
authors.forename: Bhavini
authors.initials: B
authors.lastname: Whiteside
authors.forename: Siobhan
authors.initials: S
authors.lastname: Barry
authors.forename: Taryn
authors.initials: T
authors.lastname: Jones
mesh_terms: D000328:Adult; D001315:Australia; D001930:Brain Injuries / Q000534:rehabilitation*; D004185:Disability Evaluation; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D026741:Physical Therapy Modalities; D016896:Treatment Outcome; D016138:Walking; D055815:Young Adult