Upright pedalling to drive recovery early after stroke
Rehab intervention early post stroke is vital whilst the brain is most responsive to motor input to facilitate neuroplasticity and recovery. Repetition of functional tasks including walking is key, however significant paresis limits walking practice.
This study assessed upright pedalling (UP) on subjects post stroke with considerable paresis to determine its rehab potential with pedalling considered a repetitive functional activity requiring phasic muscle activity.
The current study reported on 8 adults between 3 and 30 days post stroke during one upright cycling session. Surface EMG was used to record activity of quadriceps and hamstrings bilaterally.
Results showed people post stroke can produce smooth movements using a variety of muscle activation strategies. Of note, 3 subjects achieved smoother movements than healthy individuals at similar cycle speeds.
Authors also suggest one leg pedalling with the unaffected limb may benefit bilateral motor patterns with potential up-regulation of ipsilateral excitatory pathways to assist the hemiplegic leg.
The authors highlight the need for larger study sizes however the results highlight potential benefits of UP as a rehab intervention which can be implemented clinically early post stroke.
> From: Hancock et al., Physiotherapy 103 (2018-01-22 09:56:40) 400-406. All rights reserved to Elsevier Ltd. Click here for the online summary.