title: Effects of a rapid-resisted elliptical training program on motor, cognitive and neurobehavioral functioning in adults with chronic traumatic brain injury.
abstract: This small clinical trial utilized a novel rehabilitation strategy, rapid-resisted elliptical training, in an effort to increase motor, and thereby cognitive, processing speed in ambulatory individuals with traumatic brain injury (TBI). As an initial step, multimodal functional abilities were quantified and compared in 12 ambulatory adults with and 12 without TBI. After the baseline assessment, the group with TBI participated in an intensive 8-week daily exercise program using an elliptical trainer and was reassessed after completion and at an 8-week follow-up. The focus of training was on achieving a fast movement speed, and once the target was reached, resistance to motion was increased in small increments to increase intensity of muscle activation. Primary outcomes were: High-Level Mobility Assessment Tool (HiMAT), instrumented balance tests, dual-task (DT) performance and neurobehavioral questionnaires. The group with TBI had poorer movement excursion during balance tests and poorer dual-task (DT) performance. After training, balance reaction times improved and were correlated with gains in the HiMAT and DT. Sleep quality also improved and was correlated with improved depression and learning. This study illustrates how brain injury can affect multiple linked aspects of functioning and provides preliminary evidence that intensive rapid-resisted training has specific positive effects on dynamic balance and more generalized effects on sleep quality in TBI.
authors.affiliation: Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, 10 Center Drive, Room 1-1468, MSC 1604, Bethesda, MD, 20892-1604, USA. damianod@cc.nih.gov.
authors.forename: Diane L
authors.initials: DL
authors.lastname: Damiano
authors.affiliation: Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, 10 Center Drive, Room 1-1468, MSC 1604, Bethesda, MD, 20892-1604, USA.
authors.forename: Cristiane
authors.initials: C
authors.lastname: Zampieri
authors.affiliation: University of Maryland School of Dentistry, 650 West Baltimore Street, Baltimore, MD, 21201, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Ge
authors.affiliation: Rehabilitation Medicine Department, National Institutes of Health Clinical Center, 10 Center Drive, Room 1-1469, MSC 1604, Bethesda, MD, USA.
authors.forename: Ana
authors.initials: A
authors.lastname: Acevedo
authors.affiliation: Rehabilitation Medicine Department, Center for Neuroscience and Regenerative Medicine (CNRM), National Institutes of Health Clinical Center, 10 Center Drive, Room 1-1468, MSC 1604, Bethesda, MD, 20892-1604, USA.
authors.forename: John
authors.initials: J
authors.lastname: Dsurney
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000534:rehabilitation*; D002908:Chronic Disease / Q000534:rehabilitation; D003863:Depression / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007858:Learning / Q000502:physiology*; D008297:Male; D017063:Outcome Assessment, Health Care; D004856:Postural Balance / Q000502:physiology*; D011597:Psychomotor Performance / Q000502:physiology*; D055070:Resistance Training / Q000379:methods*; D012890:Sleep / Q000502:physiology*; D055815:Young Adult
keywords: Cognition; Coordination; Exercise; Motion; TBI