Randomized Controlled Trial: Preliminary Investigation of the Impact of High-Intensity Treadmill Gait Training on Recovery Among Persons with Traumatic Brain Injury

Exercise to treat traumatic brain injury (TBI) is a novel approach that has only become recognized in the past decade. High-intensity gait training (HIGT) has been studied in subjects following stroke; however, little research investigates similar protocols on patients with TBI. The study evaluated HIGT as an intervention for enhancing patient recovery after TBI. Adult subjects (18-65 years) who suffered TBI were randomly allocated to an intervention (HIGT) or control (low-intensity physical therapy) group given three days/week for 1 h over four weeks. Assessments included the 10-m walk test, 6-min walk test, Berg Balance Scale, five-times sit-to-stand (5TSTS), timed up and go (TUG), cognitive TUG, and Montreal Cognitive Assessment (MoCA) at day one, two weeks, four weeks, and a four-week follow-up. In addition to a trend toward improved gait speed (p < 0.1) and significantly improved endurance (p < 0.05) in the HIGT group (n = 5), both the control (n = 4) and HIGT groups demonstrated trends toward improved mobility (5TSTS, p < 0.1; TUG, p < 0.1) and significantly improved cognition (cognitive TUG, p < 0.01; MoCA, p < 0.05) over the four-week time period and at the one-month follow-up. HIGT showed longer-lasting rehabilitative effects on gait distance, endurance, mobility, and cognitive function at the four-week follow-up. This study suggests that HIGT may support functional recovery, and future work will involve increasing sample size.