Acute Effects of Assisted Cycling Therapy on Post-Stroke Motor Function: A Pilot Study

Abstract

Background. Stroke is the most common cause of long-term disability in the United States (US). Assisted Cycling Therapy (ACT) at cadences of about 80 rpm has been associated with improvements in motor and clinical function in other clinical populations. The acute effects of ACT on motor function of persons with stroke have not been investigated. Objectives. The primary purpose of this cross-over trial was to compare the effects of ACT, voluntary cycling (VC), and no cycling (NC) on upper (Box and Blocks Test) and lower extremity motor function (Lower Extremity Motor Coordination Test) in adults with chronic stroke (age: 60 ± 16 years; months since stroke: 96 ± 85). The secondary purpose was to examine average cycling cadence and ratings of perceived exertion as predictors of change in motor function following the exercise session. Methods. Twenty-two participants (female = 6, male = 16) completed one 20-min session each of ACT (mean cadence = 79.5 rpm, VC (mean cadence = 51.5 rpm), and NC on separate days in quasi-counterbalanced fashion). Results. Main effects of intervention did not differ between ACT and VC. Within-intervention analyses revealed significant (p < 0.05) pre- to posttest changes in all outcome measures for ACT but only in the Lower Extremity Motor Coordination Test on the non-paretic side for VC. Trend analyses revealed a positive relationship between average ACT cadences and improvements in upper and lower extremity motor function (p < 0.05). A positive relationship between average VC cadences and lower extremity function was also revealed (p < 0.05). Conclusion. ACT and VC produced similar acute improvements in paretic and non-paretic lower extremity motor function whereas changes in upper extremity motor function were more limited. Faster cycling cadences seem to be associated with greater acute effects.

Users’ experience of community-based power assisted exercise: a transition from NHS to third sector services

“…The functional gains associated with PAE in this study might be at least partially attributable to neuroplastic adaptation triggered through engagement with assisted exercise. Assisted cycling enhanced neuroplastic potential and motor coordination for PwS (Holzapfel et al, 2019 ). Assisted exercise prior to physical rehabilitation interventions has been associated with enhanced neuroplastic potential (Linder et al, 2019 ).…”

“…Perspectives on optimal speed settings when using PAE equipment were varied amongst the participants as some believed that a fast pace generated a more intensive workout whilst others perceived the slow settings to be harder. Assisted cycling intervention protocols have stipulated a faster pace of movement than would be voluntarily initiated by the participant (Holzapfel et al, 2019 ; Linder et al, 2019 ) and this was deemed to enhance neuroplasticity and improve motor coordination. However, it may be hypothesized that improvements in muscular endurance and postural control could be more effectively stimulated through slowly paced assisted movement.…”

“…Improvements in physical function and exercise behaviours are reported amongst people with complex impairments who have participated in adapted or assisted exercise interventions (Kerr et al, 2019 ; Lloyd et al, 2018 ). The impact of assisted pedalling interventions for PwS include increased aerobic capacity, enhanced neuroplasticity and improved motor coordination (Holzapfel et al, 2019 ; Linder et al, 2019 , 2015 ). Seated Power Assisted Exercise (PAE) machines go beyond assisted pedalling as the range of equipment is designed to assist repeated, multi-directional, global movement patterns.…”