Cardiorespiratory capacity after weight-supported treadmill training in patients with traumatic brain injury

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.