Effects of electric stimulation - Assisted cycling training in people with chronic stroke

Objective: To evaluate whether leg cycling training in subjects with chronic stroke can improve cycling performance, aerobic capacity, muscle strength, and functional performance and to determine if electric stimulation (ES) to the contralateral (paretic) leg during cycling has additional effects over cycling without ES. Design: A randomized controlled trial, with a partial double-bind design. Setting: A rehabilitation center. Participants: Twelve stroke patients (range, 18-70y), more than 5 months poststroke, with lower-extremity hemiparesis. Intervention: Subjects were randomly assigned to groups that performed cycling exercise, one with ES evoking muscle contractions and a control group with ES not evoking muscle contractions. Subjects, blinded for group assignment, trained twice a week for 6 weeks. Main Outcome Measures: Changes in aerobic capacity and maximal power output, functional performance, and lower-limb muscle strength. Results: Aerobic capacity and maximal power output significantly increased by 13.8% +/- 19.1% and 38.1% +/- 19.8%, but muscle strength was not significantly enhanced after training. Functional performance improved (ie, scores on the Berg Balance Scale increased by 6.9% +/- 5.8% (P = .000) and the six-minute walk test improved by 14.5% +/- 14.1% (P = .035). There was no significant effect on the Rivermead Mobility Index (P = .165). Training-induced changes were not significantly different between the 2 groups. Changes in cycling performance and aerobic capacity were not significantly related to changes in functional performance. Conclusions: This study showed that a short cycling training program on a semirecumbent cycle ergometer can markedly improve cycling performance, aerobic capacity, and functional performance of people with chronic stroke. The use of ES had no additional effects in this specific group of subjects with chronic stroke.