Now we just need followup research on stroke, only 9 years since this first came out. Just shows you how incompetent stroke leadership is. I needed no cardio training since even three years after stroke I still had the fitness level of an athlete.
Fitness training for cardiorespiratory conditioning after traumatic brain injury
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This is an update of "Fitness training for cardiorespiratory conditioning after traumatic brain injury." Cochrane Database Syst Rev. 2008 Apr 16;(2):CD006123.
Abstract
Reduced cardiorespiratory fitness (cardiorespiratory deconditioning) is a
common consequence of traumatic brain injury (TBI). Fitness training
may be implemented to address this impairment.The primary objective of
this updated review was to evaluate whether fitness training improves
cardiorespiratory fitness in people who have sustained a TBI. The
secondary objectives were to evaluate whether fitness training improves
body function and structure (physical and cognitive impairments,
psychological responses resulting from the injury), activity limitations
and participation restrictions in people who have sustained a TBI as
well as to evaluate its safety, acceptance, feasibility and
suitability.We searched 10 electronic databases (the Cochrane Injuries
Group Trials Register; the Cochrane Central Register of Controlled
Trials (CENTRAL); Embase; PubMed (MEDLINE); CINAHL; AMED; SPORTDiscus;
PsycINFO; PEDro and PsycBITE) and the International Clinical Trials
Registry Platform for relevant trials. In addition we screened reference
lists from systematic reviews related to the topic that we identified
from our search, and from the included studies, and contacted trialists
to identify further studies. The search was run in August
2017.Randomised controlled studies with TBI participants were eligible
if they compared an exercise programme incorporating cardiorespiratory
fitness training to usual care, a non-exercise intervention, or no
intervention.Two authors independently screened the search results,
extracted data and assessed bias. We contacted all trialists for
additional information. We calculated mean difference (MD) or
standardised mean difference (SMD) and 95% confidence intervals (CI) for
continuous data, and odds ratio with 95% CI for dichotomous data. We
pooled data when there were sufficient studies with homogeneity.Two new
studies incorporating 96 participants were identified in this update and
were added to the six previously included studies. A total of eight
studies incorporating 399 participants are included in the updated
review. The participants were primarily men aged in their mid-thirties
who had sustained a severe TBI. No studies included children. The
studies were clinically diverse with regard to the interventions, time
postinjury and the outcome measures used. At the end of intervention,
the mean difference in peak power output was 35.47 watts (W) in favour
of fitness training (MD 35.47 W, 95% CI 2.53 to 68.41 W; 3 studies, 67
participants; low-quality evidence). The CIs include both a possible
clinically important effect and a possible negligible effect, and there
was moderate heterogeneity among the studies.Five of the secondary
outcomes had sufficient data at the end of intervention to enable
meta-analysis: body composition (SMD 0.29 standard deviations (favouring
control), 95% CI -0.22 to 0.79; 2 studies, 61 participants; low-quality
evidence), strength (SMD -0.02 (favouring control), 95% CI -0.86 to
0.83; 2 studies, 23 participants; very low-quality evidence), fatigue
(SMD -0.32 (favouring fitness training), 95% CI -0.90 to 0.26; 3
studies, 130 participants; very low-quality evidence), depression (SMD
-0.43 (favouring fitness training), 95% CI -0.92 to 0.06; 4 studies, 220
participants; very low-quality evidence), and neuromotor function (MD
0.01 m (favouring fitness training), 95% CI -0.25 to 0.27; 2 studies,
109 participants; moderate-quality evidence). It was uncertain whether
fitness training was more or less effective at improving these secondary
outcomes compared to the control interventions. Quality of life was
assessed in three trials, but we did not pool the data because of
substantial heterogeneity. Five of the eight included studies had no
dropouts from their intervention group and no adverse events were
reported in any study.There is low-quality evidence that fitness
training is effective at improving cardiorespiratory deconditioning
after TBI; there is insufficient evidence to draw any definitive
conclusions about the other outcomes. Whilst the intervention appears to
be accepted by people with TBI, and there is no evidence of harm, more
adequately powered and well-designed studies are required to determine a
more precise estimate of the effect on cardiorespiratory fitness, as
well as the effects across a range of important outcome measures and in
people with different characteristics (e.g. children). In the absence of
high quality evidence, clinicians may be guided by pre-exercise
screening checklists to ensure the person with traumatic brain injury is
safe to exercise, and set training parameters using guidelines
established by the American College of Sports Medicine for people who
have suffered a brain injury.
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