Objective: To investigate the effect of increasing effort on energy cost as measured by oxygen consumption (V.O2) during cycling exercise in individuals early after acquired brain injury (ABI).
Design: An experimental correlation design.
Setting: Specialist neurorehabilitation centre.
Participants: Thirty-eight individuals were recruited early after acquired brain injury. Nine individuals had spasticity; Ashworth Scale >1 in either upper or lower limbs.
Intervention: The V.O2 was measured in relation to workload during a graded exercise test.
Results: The V.O2 increased in a linear fashion with increases in workload in 34 individuals. Only one individual with spasticity demonstrated a nonlinear relationship.
Conclusion: Increasing the workload during cycling exercise does not disproportionately increase energy cost in most individuals with spasticity early after ABI.
Get full access to this article
View all access options for this article.
References
1.
Moran, AJ. Six cases of severe head injury treated by exercise in addition to other therapiesMed J Aust1976; 1: 396–397.
2.
Gordon WA, Sliwinski M, Echo J, McLoughlin M, Sheerer M, Meili TE. The benefits of exercise in individuals with traumatic brain injury: a retrospective study. J Head Trauma Rehabil1998; 13: 58–67.
3.
Wolman RL, Cornall C, Fulcher K, Greenwood R. Aerobic training in brain injured patients. Clin Rehabil1994; 8: 253–257.
4.
Hunter M, Tomberlin J, Kirkikis C, Kuna ST. Progressive exercise testing in closed head-injured subjects: comparison of exercise apparatus in assessment of a physical conditioning program. Phys Ther1990; 70: 363–371.
5.
Jankowski LW, Sullivan SJ. Aerobic neuromuscular training: effect on the capacity, efficiency and fatigability of patients with traumatic brain injuries. Arch Phys Med Rehabil1990; 71: 500–504.
6.
Macko RF, Katzel LI, Yataco A et al. Low-velocity graded treadmill stress testing in hemiparetic stroke patients. Stroke1997; 28: 989–992.
7.
Potempa K, Lopez M Braun LT, Szidon PJ, Fogg L, Tincknell T. Physiological outcomes of aerobic exercise training in hemiparetic stroke patients. Stroke1995; 26: 101–105.
8.
Bateman A, Greenwood RJ, Scott OM. Exercise tolerance, quadriceps strength and fatiguability and functional ability after recent brain injury. SRR2000.
9.
Bard, G. Energy expenditure of hemiplegic subjects during walking. Arch Phys Med1963; 44: 368–372.
10.
Astrand PO, Rodahl K. Physiological bases of exercise. In: Textbook of work physiology. New York: McGraw-Hill, 1988: 300–301.
11.
Wilmore JH, Costill DL. Physiology of sport and exercise. London: Human Kinetics, 1999.
12.
Taylor H, Buskirk, E, Henschel A. Maximal oxygen uptake as an objective measure of cardiorespiratory performance. J Appl Physiol1955; 8: 73–78.
13.
Fisher SV, Guillickson G. Energy cost of ambulation in health and disability: a literature review. Arch Phys Med Rehabil1978; 59: 124–133.
14.
Landin S, Hagenfeldt L, Saltin B et al. Muscle metabolism during in exercise in hemiparetic patients. Clin Sci Mol Med1977; 53: 257–269.
15.
Hoskins TA. Physiologic responses to known exercise loads in hemiparetic patients. Arch Phys Med Rehabil1975; 56: 544-544.
16.
Macko RF, DeSouza CA, Tretter LD et al. Treadmill aerobic exercise training reduces the energy expenditure and cardiovascular demands of hemiparetic gait in chronic stroke patients. Stroke1997; 28: 326–330.
17.
American College of Sports Medicine. Guidelines for graded exercise testing and training, fifth edition. Philadelphia: Lea and Febiger, 1995.
18.
Sjostrand T. Changes in the respiratory organs of workmen at an ore smelting works. Acta Med Scand1947; 196 (suppl): 687–699.
Brown DA, Kautz SA. Increased workload enhances force output during pedalling exercises in persons with post stroke hemiplegia. Stroke1998; 29: 595–606.
21.
Butefisch C, Hummelsheim H, Denzler P, Mauritz KH. Repetitive training of isolated movements improves the outcome of motor rehabilitation of the centrally paretic hand. J Neurol Sci1995; 130: 59–68.
22.
Sharp SA, Brouwer BJ. Isokinetic strength training of the hemiparetic knee: effects on function and spasticity. Arch Phys Med Rehabil1997; 78: 1231–1236.
23.
Smith GV, Silver KHC, Goldberg AP, Macko RR. ‘Task-orientated’ exercise improves hamstring strength and spastic re‘exes in chronic stroke patients. Stroke1999; 30: 2112–2118.
24.
Teixeira-Salmela LF, Olney SJ, Nadeau S, Brouwer B. Muscle strengthening and physical conditioning to reduce impairment and disability in chronic stroke survivors. Arch Phys Med Rehabil1999; 80: 1211–1218.
25.
Jones NL, Kane JW. Quality control of exercise test measurements. Med Sci Sport Exerc1979; 11: 368–372.
26.
Dawes H, Roach N, Wade D, Scott OM. Variability of rating of exercise intensity perception after brain injury. Paper presented at the Proceedings of The British Psychological Society Annual Conference, Conference Proceedings. Belfast. April.
27.
Landin D, Hagenfeldt L, Saltin B. Muscle metabolism during exercise in hemiparetic patients. Clin Sci Mol Med1977; 53: 257–269.
28.
Bateman A, Culpan J, Dawes H, Tunstall Pedoe D, Scott OM, Greeenwood R. Exercise tolerance in patients who have suffered recent brain injury. J Sports Sci1999; 17: 27–28.
