The Pulse

Cycling Exercise in Rehabilitation to Improve Coordination and Normalize Muscle Tone

Posted by ACP - Accelerated Care Plus on Aug 26, 2020 9:25:57 PM

Physical and occupational therapists treat many individuals who present with impaired coordination, motor control, balance and tone. These individuals may have a wide range of diagnoses, from neurologically involved, such as cerebral vascular accident (CVA) and Parkinson’s disease, to orthopedic involvement such as post-total knee replacement (TKR). The common goal of improving functional mobility and outcomes may be achieved by the addition of research-supported cycling and biophysical agents.

Coordination, balance, and gait:

  • Cycling improved ambulatory function in patients with stroke and may be used to improve walking ability. (Ofori et al., 2019)
  • Stationary cycling exercise training is an effective intervention for increasing balance and gait abilities in chronic stroke patients. (Kim et al., 2015)
  • A pedaling-based rehab program implemented two days after TKR for two weeks was superior to standard multi-exercise protocol in functional outcomes (6MWT, 10MWT, and TUG) and self-reported outcomes (Oxford Knee Score and EQ-5D). (Sattler et al., 2019)

Normalizing tone:

  • Cycling with functional electrical stimulation using interval timing has positive effects on spasticity and range of motion in post stroke patients. (Shariat et al., 2019)
  • Patients approximately two years post-stroke trained on an arm ergometer decreased spasticity, increased force, and range of motion. (Diserens et al., 2007)
  • High-cadence cycling for individuals with Parkinson’s disease showed acute and sustained improvements in motor function and mobility. (Ridgel & Ault, 2019)

Improving Coordination, Balance, and Gait Using the OmniCycle®: interactive biofeedback exercises (symmetry bar, road, traffic jam, porcupine, and soccer) to address right and left coordination, speed, and control which may improve balance and gait.

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Tone Reduction using the OmniCycle®: interactive biofeedback exercise with bar graph, interval training, high cadence cycling, and cycling with or without patterned electrical neuromuscular stimulation (PENS) may assist in tone reduction.

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For specific instructions regarding how to use these protocols with your patients, please contact your CPC or Remote Clinical Services at 800-350-1100, option 2.

References:
Diserens, K., Perret, N., Chatelain, S., Bashir, S., Ruegg, D., Vuadens, P., & Vingerhoets, F. (2007). Journal of Neurological Sciences, 253, 18-24. http://doi.org.10.1016/j.jns.2006.10.021
Kim, S. J., Cho, H. Y., Kim, Y. L., & Lee, S.M. (2015). Effects of stationary cycling exercise on the balance and gait abilities of chronic stroke patients. Journal of Physical Therapy Science, 27(11), 3529-3531.
http://doi.org/10.1589/jpts.27.3529
Ofori, E. K., Frimpong, E., Ademiluyi, A., & Olawale, O. A. (2019). Ergometer cycling improves the ambulatory function and cardiovascular fitness of stroke patients-a randomized controlled trial. Journal of Physical
Therapy Science, 31, 21-216. http://doi.org/10.1589/jpts.28.211
Rigel, A. L., 7 Ault, D. L. (2019). High-Cadence Cycling Promotes Sustained Improvements in Bradykinesia, Rigidity, and Mobility in Individuals with Mild-Moderate Parkinson’s Disease. Parkinson’s Disease,
http://doi.org/10.1155/2019/4076862
Sattler, L.N., Hing, W. A., Vertullo, C. J. (2019). Pedaling-Based Protocol Superior to a 10-Exercise, Non-Pedaling Protocol for Postoperative Rehabilitation After Total Knee Replacement: A Randomized Controlled Trial.
Journal of Bone and Joint Surgery, 101, 688-695. http://dx.doi.org/10.2106/JBJS.18.00898
Shariat, A., Ansari, N. N., Honarpishe, R., Moradi, V.,Hakakzadeh, A., Cleland, J. A., &Kordi, R. (2019). Effect of cycling and functional electrical stimulation with linear and interval patterns of timing on gait parameters
in patients after stroke: a randomized controlled trial. Disability and Rehabilitation, http://doi.org/10.1080/09638288.2019.1685600

Topics: Clinical Tip, Cardiopulmonary, Neuro Rehab

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