Aerobic Responses to FES-Assisted and Volitional Cycling in Children with Cerebral Palsy

Abstract

Recumbent stationary cycling is a potential exercise modality for individuals with cerebral palsy (CP) that lack the postural control needed for upright exercises. Functional electrical stimulation (FES) of lower extremity muscles can help such individuals reach the cycling intensities that are required for aerobic benefits. The aim of this study was to examine the effect of cycling with and without FES assistance to that of a no-intervention control group on the cardiorespiratory fitness of children with CP. Thirty-nine participants were randomized to a FES group that underwent an 8-week FES-assisted cycling program, the volitional group (VOL), who cycled without FES, or a no-intervention control group (CON) (15 FES, 11 VOL, 13 CON). Cadence, peak VO2, and net rise in heart rate were assessed at baseline, end of training, and washout (8-weeks after cessation of training). Latent growth curve modeling was used for analysis. The FES group showed significantly higher cycling cadences than the VOL and CON groups at POST and WO. There were no differences in improvements in the peak VO2 and peak net HR between groups. FES-assisted cycling may help children with CP attain higher cycling cadences and to retain these gains after training cessation. Higher training intensities may be necessary to obtain improvements in peak VO2 and heart rate.

Community‐based physical activity interventions for adolescents and adults with complex cerebral palsy: A scoping review

“…The research designs used in the reviewed studies were randomized controlled trials ( n = 5), non‐randomized controlled trials ( n = 1), randomized crossover trial ( n = 1), single‐subject design ( n = 5), pre–post test studies ( n = 4), and a repeated measures study ( n = 1). Study sample sizes were generally small: the largest trial enrolled 36 participants, 13 of whom had gross motor classifications in GMFCS level IV 14 . The community settings for the studies included schools ( n = 4), participants' homes ( n = 3), gymnasia ( n = 2), swimming pools ( n = 2), an indoor track and field facility ( n = 1), a day programme ( n = 1), and other community settings ( n = 2).…”

Quantification of Cycling Smoothness in Children with Cerebral Palsy

“…There were no criteria for the weight of participants. The result of the cycling intervention is previously published by our group [30]. Here, we used the crank angles collected from one of the cohort groups in the study, only to assess the capabilities of the aforementioned metrics in quantifying smoothness when subjects did not cycle smoothly.…”

“…Despite the different cycling systems for CP and TD groups, anthropometric differences of individuals within and across groups were minimized by standardizing positioning in both cycling setups (Figure 1C). Additionally, the force transducer pedals used for the TD group by Johnston et al, [31] also used on the recumbent tricycle used for the CP group in Sansare et al [16,30], which further standardized foot and shank positioning across the two datasets. The bicycle crank and spindle assembly for both systems were instrumented with sensors to indicate crank position and cadence.…”

“…Data were analyzed using customized software (MATLAB The Mathworks, Inc., Natick, MA, USA). Note that, here we used the TD dataset, from Johnston et al [31], as the representative dataset of smooth cycling, and the CP dataset, from Sansare et al [30], was used as the representative dataset of unsmooth cycling. The crank angle data from the CP group were visually less smooth when compared with those of TD group.…”

“…The focus of this paper is comparison between six different types of smoothness metrics and not comparison between CP versus TD groups. The result of cycling intervention on CP and comparison between CP and TD groups were published in Sansare et al [30], and Johnston et al [31], respectively.…”