Effects of a static bicycling programme on the functional ability of young people with cerebral palsy who are non‐ambulant

Abstract

This study investigated the effects of exercise on the motor function of 11 young people (10 females, one male; age range 11-15y; mean age 12y 7mo [SD 1y 4mo]) with cerebral palsy (CP) who were non-ambulant (Gross Motor Function Classification System Levels IV or V), using an adapted static bicycle. Three participants had dyskinetic quadriplegia, seven had spastic quadriplegia, and one had spastic diplegia. The study used an ABA design with participants acting as their own controls with 6-week baseline, 6-week exercise (three sessions a week), and 6-week follow-up periods. Outcomes were assessed with the Gross Motor Function Measure (GMFM)-66 and GMFM-88. A 'graded exercise test' determined pedalling resistance, and 'overload' was ensured by increasing the duration and speed of pedalling. Results showed significant improvements in GMFM-66 (p=0.010) and in GMFM-88 dimensions D (Standing; p=0.012) and E (Walking, Running, and Jumping; p=0.011) over the intervention period, but not over the baseline or follow-up periods. Significant improvements were found in 'cycling' ability for duration of pedalling (p<0.001), speed (p=0.01), and resistance (p=0.001). This study demonstrates that a relatively short, clinically feasible training programme on a static bicycle can lead to valuable improvements in functional ability in young people with CP. The static bicycle provided a safe, effective means of exercise to a population with very limited opportunities for activity.

A Real-Time Fatigue Monitoring and Analysis System for Lower Extremity Muscles with Cycling Movement

“…Therefore, cycling-based movement is often used for walking training as well as the lower limb coordination training [11]. Previous research in literature even indicates that patients with stroke and cerebral palsy may improve their motor and balance abilities after an early short duration of cycling training [12,13]. …”

Stationary Cycling and Children with Cerebral Palsy: Case Reports for Two Participants

“…Test items within both dimensions (transitioning from high kneeling to standing, unilateral stance, stepping, jumping, and hopping) improved and were consistent with gains in knee extensor strength. Williams and Pountney (2007) found a greater increase on the GMFM (mean = 7.3% increase, p < .05) following a stationary cycling intervention for 11 non-ambulatory children with CP. They attributed the large gain to pre-existing low levels of functional ability and few opportunities to participate in physical activity.…”

“…Research has shown that children with CP can cycle independently but demonstrate differences in muscle recruitment patterns (Johnston, Barr, & Lee, 2007;Kaplan, 1995), joint kinematics (Johnston et al, 2007), and pedal forces (Johnston, Prosser, & Lee, 2008), compared to children without CP. A recent study showed that stationary cycling could be an effective intervention for children with CP, even those who are non-ambulatory (Williams & Pountney, 2007). After a six-week, three times weekly stationary cycling intervention, these children demonstrated improved supported standing, cruising, and stepping on the Gross Motor Function Measure (GMFM) (p = 0.01).…”

Effect of Pedal Training on Gait Speed in Children With Hemiparetic Cerebral Palsy

“…Previous studies have found that pedaling improved physical endurance as a result of improving oxygen consumption, gross motor function and oxygen uptake but none of these studies recorded an improvement in walking speed. A previous study applied on 70 ambulatory children with spina bifida reported an improvement in walking speed and step length after 4 weeks of repetitive ergometer training [18,19].…”