The effects of cycling using lower limb active-passive trainers, with or without functional electrical stimulation, on spasticity, cardiovascular fitness, function and quality of life in people with neurological disabilities; a systematic review

Lorna Paul, Alison Barclay*, Scott Rooney, Stuart Gray

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Abstract
Background; Active passive trainers (APTs) are frequently used in exercise settings as a safe, feasible way for people with neurological disabilities to exercise, however evidence regarding their efficacy is limited. The aim of the study was to review the literature investigating the effects of lower limb APT cycling, with or without functional electrical stimulation (FES), on spasticity, cardiovascular fitness, function and quality of life in neurological populations.
Methods; Five electronic databases were searched from inception to June 2021. Studies included were randomised controlled trials using lower limb APTs as a cycling intervention, included participants with neurological conditions; multiple sclerosis, spinal cord injury, stroke and Parkinson’s disease and at least one outcome related to spasticity, cardiovascular fitness, physical function or quality of life.
Results; Twelve articles were included (n=423 participants, 52% male), 6 used FES assisted APT interventions and 6 APT interventions alone. A meta-analysis showed no improvements in walking speed (p=0.31), however did show statistically significant improvement in walking endurance but only included stroke studies (6MWT performance, p<0.00001). A significant improvement in spasticity was found by three studies (2 APT alone, 1 APT + FES). One study reported improvement in areas of quality of life, but few considered cardiovascular fitness.
Conclusions; The included studies had heterogeneous designs, outcome measures and exercise prescription, and included participants with differing disability levels making comparisons difficult. APT interventions appear to improve walking endurance in people with neurological conditions, however the effect on other outcomes remains unclear. In addition, it remains unclear whether FES assisted cycling is more beneficial than APT cycling alone.
Original languageEnglish
JournalInternational Journal of Therapy and Rehabilitation
Publication statusAccepted/In press - 22 Dec 2022

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