Acute bouts of assisted cycling therapy for people with chronic stroke-related deficits

Background: Stroke is a leading cause of long-term disability in the United States (US). Assisted Cycling Therapy (ACT) incorporates the use of an electric motor to enhance the rotations per minute (rpm). ACT of about 80 rpm, has been associated with improvements in motor, cognitive, and clinical function. The acute effects of ACT on motor and cognitive function of persons with stroke induced deficits have not been investigated.

Purpose: To compare the acute effects of ACT, voluntary cycling (VC), and no cycling (NC) on upper and lower extremity motor function and executive function in adults with chronic stroke (age: 60 ± 16 years; months since stroke: 96 ± 85).

Methods: Twenty-two participants (gender: female = 6, male = 16; types: ischemic = 12, hemorrhagic = 10; sides: left lesion = 15, right lesion = 7) completed one session of ACT, one session of VC and one session of NC on separate days using a 3 x 3 crossover design.

Results: ACT lead to greater improvements in lower and upper extremity function on the paretic and non-paretic side than VC or NC (all p < 0.05), except in the non-paretic lower extremity where ACT and VC produced similar improvement (both p < 0.05). ACT and VC, but not NC, were associated with improvements in inhibition (p < 0.05). A positive relationship between cadence and motor function (P < 0.05) was found. Ratings of perceived exertion shared an inverted-U shaped relationship with measures of processing speed (p < 0.05) and a negative linear relationship with measures of executive function (p < 0.05).

Conclusion: ACT appears to benefit paretic and non-paretic motor function globally whereas the benefits of VC are more task specific. Faster cycling cadence was associated with greater improvements in global motor function. ACT and VC seem to carry similar acute benefits in inhibition.