Forced-Rate Aerobic Cycling Improves Locomotor Function and Gait Biomechanics in Individuals With Chronic Stroke: A Randomized Controlled Trial.

Abstract

While cycling and walking are different motor tasks, both require the rapid reciprocal activation and relaxation of lower extremity muscles in a synergistic manner, promoting coordination patterns similar to walking. The aim of this secondary analysis was to examine the effects of forced-rate cycling on gait biomechanics after stroke. A randomized controlled trial was conducted investigating the neuroplastic effects of forced-rate cycling on upper extremity motor recovery in individuals ( n = 60) after stroke. In this secondary analysis, a subset of participants ( N = 45) completed biomechanical gait assessment at baseline and postintervention. Gait velocity increased in the cycling group by 0.08 m/sec and in the control group by 0.02 m/sec, though a group difference was not observed ( P = 0.195). Walking capacity (6-min walk test) significantly improved by 53.3 m for the cycling group versus 15.6 m for the control group ( P = 0.0036). Improvements in spatiotemporal characteristics in the cycling group included increased step length, cadence, and time spent in single-limb support, in addition to paretic limb kinetics. Improvements in gait velocity after forced-rate cycling were accompanied by normalization of gait biomechanics rather than exaggerated compensatory strategies, supporting the use of aerobic cycling as a viable and safe intervention to improve locomotor control after stroke.