Cycling power symmetry in patients early post-stroke with and without feedback: A pilot study

Research Objectives: To determine the safety and feasibility of a recumbent cycling program in individuals early post stroke when provided biofeedback (BFB) about power symmetry.

Design: Individuals were randomized to either a treatment group that received the intervention or a standard-of-care control group. Individuals in the intervention group pedaled for 10 days with faded BFB.

Setting: University Inpatient Rehabilitation Facility (IRF).

Participants: Five individuals, 3 females, mean 12-days post-stroke, mean age 47 years, completed the study.

Interventions: All individuals performed submaximal cycling assessments without BFB on days 1 and 12 to determine peak heart rate and resistance at exhaustion. Day 1 and day 12 allowed assessment on cycling symmetry. The intervention group performed ten 30-minute sessions of cycling on a recumbent cycle ergometer fitted with commercial power meter pedals and head unit. They were provided faded BFB visually on a screen in front of them about total percent power contribution of each limb. The standard of care group underwent usual rehabilitation interventions.

Main Outcome Measures: Safety was determined by all individuals completing the intervention without health concerns (e.g. cardiovascular or orthopedic). Feasibility was determined by the ability to perform this type of intervention in an IRF setting with individuals early post-stroke. The limb symmetry index was used to evaluate power symmetry which is equal to the hemiparetic limb power divided by the non-hemiparetic limb power times 100.

Results: The intervention was safe (no adverse events) and feasible. Participants in the treatment group presented an average increase of 13.76 in power symmetry compared to an average increase of 3.15 in the control group.

Conclusions: The results of this work have potential to improve gait symmetries in an individual’s early post-stroke compared to traditional therapy. The subacute phase is the optimal time for capitalizing on neuroplasticity and preventing ingrained deficient habits. Additionally, improved power production capacity in the hemiparetic limb may directly result in improved gait symmetry by improving weight shift.

Author(s) Disclosures: The authors have nothing to disclose.