Aerobic exercise for a patient with chronic multisystem impairments

Many patients with long-term disabilities have inactive lifestyles that put them at risk for chronic diseases and secondary disabilities. The purpose of this case report is to illustrate the process of aerobic exercise prescription for a patient with chronic multisystem impairments. The patient was a 43-year-old man who incurred a traumatic brain injury and multiple fractures in a motorcycle accident 15 years previously. He subsequently developed heterotopic ossification around the right hip. In addition, the patient had a history of smoking. We chose a "nontraditional" mode of exercise for the patient that we believed would be safe and effective and would accommodate his neurologic and orthopedic impairments. The mode of exercise used was an apparatus in which the upper and lower extremities alternately flexed and extended in a nonreciprocal fashion. The patient attended 12 exercise sessions over a 1-month period, during which he demonstrated acute and chronic physiological responses appropriate for the exercise stimulus.