RECOMMENDATION 1

Post learning summary and key takeaways​

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  • Reduced aerobic fitness is a common secondary physical impairment after msTBI and therefore fitness training should be an essential part of rehabilitation.
  • Improved aerobic fitness is likely to provide multiple benefits including increasing capacity to return to necessary and preferred physical activities.
  • Fitness training should be individually-tailored and delivered across the continuum of care.
  • Pre-exercise screening and fitness testing is essential to ensure fitness training safety and effective and suitable training parameters.
  • Knowing pre-injury physical activity history and post-injury impairments and injuries are essential aspects of pre-exercise screening.
  • The need for medical clearance before fitness testing and training depends on results of screening and local policies and procedures.
  • Standardised fitness testing protocols may not be suitable for people after msTBI; there are TBI specific protocols that enable individualisation and slower speeds for those with mobility limitations.
  • Fitness test results can be used to compare change in fitness between tests, compare with normative data, determine capacity to return to pre-injury activities, set global participation-level goals with sub-goals, and set fitness training parameters.
  • Frequency, intensity, time, and type (FITT) training parameters for people after msTBI should be individualised, based on fitness test results, taking into account exercise history, exercise specificity and preferences and aim for 3-5 sessions/week, 40-85% HRR method, 20-60mins of exercise using large muscle groups.