OBJECTIVE: To compare the effects of a supervised fitness centre-based exercise programme with an unsupervised home-based exercise programme on cardiorespiratory fitness and psychosocial functioning in people with traumatic brain injury. DESIGN: Multi-centre, assessor-blinded, parallel group, randomized controlled trial. PARTICIPANTS: Sixty-two participants with severe traumatic brain injuries, who could walk at a speed exceeding 1 m/sec, discharged from 3 brain injury units. INTERVENTIONS: The fitness centre group completed a combined fitness and strength training exercise programme supervised by a personal trainer in a local fitness centre 3 times per week for 12 weeks. The home group completed a similar exercise programme unsupervised at home. MAIN OUTCOME MEASURE: Cardiorespiratory fitness measured using the modified 20-m shuttle test. RESULTS: Both groups improved in fitness: the maximal velocity achieved on the modified 20-m shuttle test increased with intervention and was maintained at follow-up. However, the difference between groups was not significant (mean between-group difference (95% confidence interval) 0 m/sec (-0.6 to 0.6) at the end of intervention). There were also no between-group differences in psychosocial functioning at the end of intervention or at follow-up. CONCLUSION: Both interventions were equally effective at improving cardiorespiratory fitness in adults with traumatic brain injuries.

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