Paralyzed But Still Cycling

Functional electrical stimulated cycling can improve condition for those with spinal cord injury

(RxWiki News) Just because someone can’t voluntarily move their legs doesn’t mean they can’t ride a bike. Researchers are taking a closer look at special exercise bikes for these patients.

A recent small study looked at the effects of simulated bicycle exercise on people who have lost the use of their lower body through spinal cord injury.

The study found that simulated bicycle exercise as a part of a rehabilitation program can help those paralyzed by spinal cord injuries.

Improvements were seen in movement coordination, interpretation of the senses and physical aspects like muscle mass and fat.

"Discuss exercise opportunities with your doctor."

John W. McDonald, MD, PhD of the International Center for Spinal Cord Injury at the Kennedy Krieger Institute and colleagues studied 45 people who were paralyzed from a spinal cord injury for more than 16 months after their injury.

Twenty-five of the people were assigned to a functional electrical stimulation (FES) cycling group and 20 people who matched in age, gender, injury severity and injury duration were in a comparison group.

The comparison group received stretching physical therapy.

FES uses electrical currents to activate nerves and stimulate movement in muscles that are normally interrupted due to spinal cord injury. In the case of FES cycling, electrical pulses cause the legs of the person to cycle on a modified stationary bicycle.

By experiencing simulated cycling, the person undergoes exercise similar to what a non-paralyzed person is able to do by walking.

The participants in the FES cycling group completed an average of 10,466 cycles per week for 29.5 months. The researchers measured change in neurological function, strength, flexibility, measurements of muscle, fat and bone, blood quality and quality of life.

Neurological function is the ability of the brain and the nerves to work together. Poor neurological function can affect movement, speech and interpretation of the senses.

Researchers saw an improvement in motor function in 80 percent of the FES cycle group and 45 percent of the control group.

There was also more improvement in the FES cycling group in response to sensation.

Fifty-six percent of the FES cycling group improved their response to a pinprick compared to 25 percent of the control group. Response to light touch scores improved in 56 percent of the FES cycling group and only 30 percent of the controls.

FES cycling also improved quality of life scores, muscle strength without increasing stiffness and total thigh fat. The reduction in total thigh fat is important because two-thirds of those with chronic spinal cord injury have glucose intolerance, a condition associated with muscle fat.

The researchers noted that exercise can play an important role in recovery, even years after an injury. They recommend paralyzed people and doctors integrate FES cycling into their rehabilitation regime.

Funding was provided by the Deans Fund at Washington University School of Medicine, Barnes-Jewish Hospital Foundation, the Barnes-Jewish Hospital Auxiliary Foundation, Christopher Reeve Paralysis Foundation, the Nextsteps Foundation, the Sam Schmidt Foundation, Gateway to a Cure Foundation, the Eric Westacott Foundation and the Intramural Research Program at the National Institutes of Health Clinical Center.

The study was published in the Journal of Spinal Cord Medicine.

No conflicts of interest were reported.

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Review Date: 
March 14, 2013