title: Independent, Community-Based Aerobic Exercise Training for People With Moderate-to-Severe Traumatic Brain Injury.
abstract: To determine whether people with moderate-to-severe traumatic brain injury (TBI) can adhere to a minimally supervised, community-based, vigorous aerobic exercise program.
  
  
  
  Prospective trial.
  
  
  
  Young Men's Christian Association (YMCA) facilities.
  
  
  
  Community-dwelling volunteers (N=10; 8 men, 2 women; age range, 22-49y) 6 to 15 months after moderate-to-severe TBI.
  
  
  
  Participants received memberships to local YMCAs and brief orientations to exercise. They were then asked to independently complete ≥12 weeks of ≥3 training sessions per week, performed at 65% to 85% of maximum heart rate for ≥30 minutes per session. Participants could self-select exercise modality, provided they met intensity and duration targets. Programmable heart rate monitors captured session intensity and duration.
  
  
  
  Independence with equipment and facility use and compliance with training goals (session frequency, duration, intensity, total weeks of training).
  
  
  
  All participants achieved independence with equipment and facility use. All met at least 2 of 4 training goals; half met all 4 goals. Participants averaged (±SD) 3.3±0.7 sessions per week for 13 weeks (range, 6-24). Average ± SD session duration was 62±23 minutes, of which 51±22 minutes occurred at or above individuals' heart rate training targets.
  
  
  
  People in recovery from moderate-to-severe TBI can, with minimal guidance, perform vigorous, community-based exercise. This suggests that decentralized exercise may be logistically and economically sustainable after TBI, expanding its potential therapeutic utility and rendering longer-duration exercise studies more feasible.
authors.affiliation: Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address: drdevine@irehabconsultants.com.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Devine
authors.affiliation: Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA; Berenson-Allen Center for Noninvasive Brain Stimulation, Brain Fit Club, Division for Brain Stimulation and Cognitive Training, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Wong
authors.affiliation: Department of Cardiology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Ernest
authors.initials: E
authors.lastname: Gervino
authors.affiliation: Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA; Berenson-Allen Center for Noninvasive Brain Stimulation, Brain Fit Club, Division for Brain Stimulation and Cognitive Training, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Pascual-Leone
authors.affiliation: Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Alexander
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000534:rehabilitation*; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D015599:Trauma Severity Indices
keywords: Brain injuries; Exercise; Rehabilitation