Functional Electrical Stimulation–Assisted Active Cycling—Therapeutic Effects in Patients With Hemiparesis From 7 Days to 6 Months After Stroke: A Randomized Controlled Pilot Study

Bauer, Petra; Krewer, Carmen; Golaszewski, Stefan; Koenig, E.; Müller, Friedemann

doi:10.1016/j.apmr.2014.09.033

Cited by 45 publications

(76 citation statements)

References 40 publications

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“…Some studies have also observed promising improvements in terms of walking endurance and gait speed 19,33. Different therapies, such as Functional Electrical Stimulation 1,5 and biofeedback,14,22 used together with cycling training, seem to enhance its therapeutic effects, but further investigations are needed to identify the task characteristics, which maximize locomotor improvements 3…”

Section: Introductionmentioning

confidence: 99%

Neuro-Mechanics of Recumbent Leg Cycling in Post-Acute Stroke Patients

et al. 2016

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Cycling training is strongly applied in post-stroke rehabilitation, but how its modular control is altered soon after stroke has been not analyzed yet. EMG signals from 9 leg muscles and pedal forces were measured bilaterally during recumbent pedaling in 16 post-acute stroke patients and 12 age-matched healthy controls. Patients were asked to walk over a GaitRite mat and standard gait parameters were computed. Four muscle synergies were extracted through nonnegative matrix factorization in healthy subjects and patients unaffected legs. Two to four synergies were identified in the affected sides and the number of synergies significantly correlated with the Motricity Index (Spearman’s coefficient = 0.521). The reduced coordination complexity resulted in a reduced biomechanical performance, with the two-module sub-group showing the lowest work production and mechanical effectiveness in the affected side. These patients also exhibited locomotor impairments (reduced gait speed, asymmetrical stance time, prolonged double support time). Significant correlations were found between cycling-based metrics and gait parameters, suggesting that neuro-mechanical quantities of pedaling can inform on walking dysfunctions. Our findings support the use of pedaling as a rehabilitation method and an assessment tool after stroke, mainly in the early phase, when patients can be unable to perform a safe and active gait training.Electronic supplementary materialThe online version of this article (doi:10.1007/s10439-016-1660-0) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Neuro-Mechanics of Recumbent Leg Cycling in Post-Acute Stroke Patients

et al. 2016

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“…Bauer P and colleagues in their study investigated whether functional electrical stimulation (FES)-assisted active cycling was more effective in improving walking and balance than active cycling without FES was. After the intervention, the authors concluded that FES-assisted active cycling seemed to be a promising intervention during rehabilitation in patients with stroke [49].…”

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confidence: 99%

Balance evaluation techniques and physical therapy in post-stroke patients: A literature review

Lendraitienė

Tamošauskaitė

Petruševičienė

et al. 2017

Neurologia i Neurochirurgia Polska

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A stroke (cerebrovascular accident - CVA) is a significant social-economic issue. Approximately 15-30% of all patients develop life-long disability, 20% require over 3 months of specialized care in healthcare institutions, and the majority of the patients never recover the ability to maintain a proper vertical position. Such CVA sequelae as balance disturbances not only negatively affect patients' daily physical activity, but also result in social isolation. A number of standardized clinical scales, tests, and instrumental examination techniques have been proposed for evaluating not only post-CVA balance function, but also any changes in this function following various interventions. Even though scientific literature lists numerous methods and instruments for the improvement of balance after a CVA, not all of them are equally effective, and there have been rather controversial evaluations of some techniques. Nevertheless, the application of the majority of the techniques as complementary or alternative measures to traditional physical therapy (PT) frequently yields better results.

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“…Stimulation (FES) and biofeedback, to improve its beneficial effects. 10 FES-cycling training showed positive benefits on muscle strength, 15,16 aerobic capacity, 17 locomotion performance, 18,19 and motor coordination. 20 The use of visual biofeedback increases patient's attention during training, improves sensorimotor integration, and, consequently, improves COPYRIGHT© EDIZIONI MINERVA MEDICA This document is protected by international copyright laws.…”

Section: Leg Cycling Can Be Also Combined With Other Therapies Such mentioning

confidence: 93%

“…Specifically, the multimodal biofeedback training, although it does not directly make the patient walk, might show better results than usual care on locomotion recovery. Indeed, it comprises a FES-6 augmented cycling training, which already showed positive effect on walking ability, 18,19 and a training specifically focused on the recovery of standing balance control, an essential requirement for locomotion. 25 Both training phases further benefitted from the use of a visual biofeedback to maximize patient's involvement.…”

Section: Leg Cycling Can Be Also Combined With Other Therapies Such mentioning

confidence: 99%

A multimodal training with visual biofeedback in subacute stroke survivors: a randomized controlled trial

Ambrosini

Peri

Nava

et al. 2020

Eur J Phys Rehabil Med

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This provisional PDF corresponds to the article as it appeared upon acceptance.A copyedited and fully formatted version will be made available soon. The final version may contain major or minor changes. Subscription: Information about subscribing to Minerva Medica journals is online at:http://www.minervamedica.it/en/how-to-order-journals.php Reprints and permissions: For information about reprints and permissionssend an email to: journals.dept@minervamedica.it -journals2.dept@minervamedica.it -journals6.dept@minervamedica.it EDIZIONI MINERVA MEDICA ABSTRACT BACKGROUND: Early interventions maximizing patient's involvement are essential to promote gait restoration and motor recovery after stroke. AIM: To evaluate the effects of a multimodal biofeedback training involving cycling augmented by Functional Electrical Stimulation (FES) and balance exercises on walking ability and motor recovery. DESIGN: Randomized controlled trial (NCT02439515). SETTING: Inpatient rehabilitation facility. POPULATION: Subacute stroke survivors (less than 6 months from the first event) with an age of up to 90 years old. METHODS: 68 participants were randomly allocated to an experimental group, performing 15 sessions of biofeedback FES-cycling training followed by 15 sessions of biofeedback balance training (20 minutes each) in addition to usual care (70 minutes), and a control group performing 30 sessions (90 minutes) of usual care. Participants were evaluated before training, after 15 sessions, after 30 sessions, and at 6-month follow-up through: gait speed (primary outcome), spatio-temporal gait parameters, Six Minute Walking Test, Functional Independence Measure, Motricity Index, Trunk Control Test, Berg Balance Scale, and Fall Efficacy Scale. RESULTS: Both groups significantly improved over time, but no group and interaction effects were found for any outcomes. The 73% of the experimental group achieved a clinically meaningful change in gait speed compared to the 38% of the control group (p-value=0.048).These percentages were even more unbalanced for patients with a moderate to severe gait impairment at baseline (91% versus 36%; p-value=0.008). COPYRIGHT© EDIZIONI MINERVA MEDICAThis document is

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Functional Electrical Stimulation–Assisted Active Cycling—Therapeutic Effects in Patients With Hemiparesis From 7 Days to 6 Months After Stroke: A Randomized Controlled Pilot Study

Cited by 45 publications

References 40 publications

Neuro-Mechanics of Recumbent Leg Cycling in Post-Acute Stroke Patients

Neuro-Mechanics of Recumbent Leg Cycling in Post-Acute Stroke Patients

Balance evaluation techniques and physical therapy in post-stroke patients: A literature review

A multimodal training with visual biofeedback in subacute stroke survivors: a randomized controlled trial

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