FES-Assisted Cycling Improves Aerobic Capacity and Locomotor Function Post-CVA.

PURPOSE: After a cerebrovascular accident (CVA) aerobic deconditioning contributes to diminished physical function. Functional Electrical Stimulation (FES)-assisted cycling is a promising exercise paradigm designed to target both aerobic capacity and locomotor function. This pilot study aimed to evaluate the effects of an FES-assisted cycling intervention on aerobic capacity and locomotor function in individuals post-CVA.

METHODS: Eleven individuals with chronic (> 6 months) post-CVA hemiparesis completed an 8-week (3x/wk; 24 sessions) progressive FES-assisted cycling intervention. VO2peak, self-selected and fastest comfortable walking speeds, gait and pedaling symmetry, 6-minute walk test (6MWT), balance, dynamic gait movements, and health status were measured at baseline and post-training.

RESULTS: FES-assisted cycling significantly improved VO2peak (12%, p=0.006), self-selected walking speed (SSWS, 0.05±0.1 m/s, p=0.04), Activities-specific Balance Confidence scale score (12.75±17.4, p=0.04), Berg Balance Scale score (3.91±4.2, p=0.016), Dynamic Gait Index score (1.64±1.4, p=0.016), and Stroke Impact Scale participation/role domain score (12.74±16.7, p=0.027). Additionally, pedal symmetry, represented by the paretic limb contribution to pedaling (PPR) significantly improved (10.09±9.0%, p=0.016). Although step length symmetry (PSR) did improve, these changes were not statistically significant (-0.05±0.1%, p=0.09). Exploratory correlations showed moderate association between change in SSWS and 6MWT (r=0.74), and moderate/strong negative association between change in PPR and PSR.

CONCLUSION: These results support FES-assisted cycling as a means to improve both aerobic capacity and locomotor function. Improvements in SSWS, balance, dynamic walking movements, and participation in familial and societal roles are important targets for rehabilitation of individuals following CVA. Interestingly, the correlation between PSR and PPR suggests that improvements in pedaling symmetry may translate to a more symmetric gait pattern.