Measures of Success
In designing a support plan, it is helpful for the trainer to understand the methods by which success is measured in training individuals with acquired brain injury.
Any level of participation is considered a success. The initial discussion of the program, the first walk down the street, the first set of curls, or posting the schedule on the wall, are all effective forms of participation. One of the more difficult aspects of the program is encouraging the individual to "buy into" the fitness process. The individual is more motivated towards the experience if he or she "owns" the program. The exercise program is his or hers; the time spent with the trainer is theirs; the effects achieved belong to them.
Consistency does not need to mean three days per week for 1 hour per session. It can mean simple follow-through one time per week, preferably the same time each week, until more time can be built in. Consistency is as important for the staff and trainer as it is for the participant. Too often, staff may be redirected to other priorities or simply fail to carry through on schedules. The participant may only be as successful as the coach in many instances.
- Positive Changes in Behavior
It is difficult to be quantitative in this category because ways of measuring behaviors are complex. Positive behavior changes have been observed in self-esteem, confidence, appetite, balance issues, self-awareness, depression, and anxiety. In the previously mentioned study completed by Gordon W., et al., there was a finding of less depression among persons with brain injury who exercise.
Rob experiences dramatic bouts of anxiety. He also suffers from poor self-confidence and self-esteem. After being involved in a fitness program for a period of months, he was observed to display more assertiveness and self-confidence with lesser bouts of anxiety.
Sam suffers periodic bouts of depression and poor appetite. During his time in the gym, his mood would elevate and his appetite would improve. Eating for this individual was related to positive changes in mood. This elevated mood would last throughout the day. Changes in behaviors and the duration of these changes should be documented.
- Body Analysis Measurements
A great way to measure success is to take measurements of body weight, body composition (if available), resting heart rate, and measurements of actual body dimensions such as the waist, hips, chest, thighs, and upper arm. These can be useful if the goals sought are based on these calibrations. Most facilities have access to weight scales, and many fitness facilities and hospitals offer body composition testing. Comparing resting heart rates before starting a fitness program to those after a few weeks can also be helpful in measuring those less visible successes. These numbers should be documented and periodically monitored to instill motivation.