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The Aetiology of Reduced Cardiorespiratory Fitness Among Adults with Severe Traumatic Brain Injury and the Relationship with Physical Activity: A Narrative Review

Published online by Cambridge University Press:  30 December 2015

Leanne Hassett ,
Anne Moseley Open the ORCID record for Anne Moseley [Opens in a new window]  and
Alison Harmer Open the ORCID record for Alison Harmer [Opens in a new window]
Leanne Hassett*
Affiliation:
Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia; and The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia
Anne Moseley
Affiliation:
The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia
Alison Harmer
Affiliation:
Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
*
Address for correspondence: Dr Leanne Hassett Lecturer, Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, 75 East Street Lidcombe, Sydney, NSW, 2141, Australia. E-mail: leanne.hassett@sydney.edu.au.
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Abstract

Reduced cardiorespiratory fitness or cardiorespiratory deconditioning is a secondary physical impairment commonly reported to affect people after traumatic brain injury (TBI), both in the short- and long-term. Eleven studies have measured peak oxygen uptake ${\rm ({\dot V}O}_{{\rm 2peak}} )$ to evaluate fitness in this population. The mean (SD) ${\rm \dot VO}_{{\rm 2peak}}$ from these studies was 27.2 (6.7) mL.kg−1·min−1, which is markedly below the average fitness level of age-matched healthy individuals. The aetiology of cardiorespiratory deconditioning has not been well evaluated among people with TBI; however, studies on prolonged bed rest and studies on the acute consequences of TBI inform our current understanding. The primary aim of this paper is to present a model to describe the physiological factors contributing to the development of cardiorespiratory deconditioning among people with severe TBI. We propose that both central and peripheral factors contribute to reduced fitness, and that these changes occur because of both the initial brain damage and trauma sustained and the prolonged and initially extreme physical inactivity that is commonly experienced after this type of injury. Reduced fitness can significantly affect the ability to return to pre-injury activities. Given that reintegration into the community is a key goal of rehabilitation among people with TBI, interventions that can prevent or reverse reduced fitness need to be implemented.

Keywords

Motor/movementcommunity re-entry/participationfatigue/sleep
Type
Review Article
Information
Brain Impairment , Volume 17 , Issue 1: Physical Activity in Neurological Populations , March 2016 , pp. 43 - 54
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2015 

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