The physiological and biomechanical effects of a short term, 8-week, eBike cycling intervention in stroke survivors

Abstract

Background: Stroke is a global health concern that results in cognitive and motor impairments, leaving survivors with chronic disability and resultant cardiovascular deconditioning. Emergent evidence has supported the use of cardiovascular training, such as cycling, as an effective rehabilitation method. However, despite such studies survivors often find cycling difficult resulting in disengagement from cycling based rehab. The introduction of electric bikes (eBikes) has the potential to aid individuals in overcoming these barriers, by providing electrical assistance, and to the best of our knowledge the potential physiological and biomechanical improvements of an eBike intervention have not been assessed. Therefore, the aim of this study was to evaluate the use of eBikes within a stroke rehabilitation program and provide the initial evidence to encourage further investigation.
Methods: A mixed method intervention case study was utilised to assess physiological and biomechanical changes. Five participants who had suffered a stroke more than 3 months prior to the study with unilateral paresis, were recruited and successfully gained doctor’s permission to take part. Assessments of ambulatory function, power balance and muscle activity were conducted either side of an 8 week eBike Background: Stroke is a global health concern that results in cognitive and motor impairments, leaving survivors with chronic disability and resultant cardiovascular deconditioning. Emergent evidence has supported the use of cardiovascular training, such as cycling, as an effective rehabilitation method. However, despite such studies survivors often find cycling difficult resulting in disengagement from cycling based rehab. The introduction of electric bikes (eBikes) has the potential to aid individuals in overcoming these barriers, by providing electrical assistance, and to the best of our knowledge the potential physiological and biomechanical improvements of an eBike intervention have not been assessed. Therefore, the aim of this study was to evaluate the use of eBikes within a stroke rehabilitation program and provide the initial evidence to encourage further investigation.
Methods: A mixed method intervention case study was utilised to assess physiological and biomechanical changes. Five participants who had suffered a stroke more than 3 months prior to the study with unilateral paresis, were recruited and successfully gained doctor’s permission to take part. Assessments of ambulatory function, power balance and muscle activity were conducted either side of an 8 week eBike intervention in which participants maintained cycle diaries.
Results: Participants one, two and four completed the intervention period and attended post-intervention assessments. Participants three and five withdrew after falling from their eBike early on in the study. Clinically meaningful improvements (1SEM) in ambulatory function were observed in participants one (1.313 ± 0.120 ms-1) and four (1.380 ± 0.043 ms-1) along with reductions in blood pressure. Improvements between limb power balance was observed in participants two and four, whilst lower limb sEMG activity (%MVIC) became more efficient as muscle co-ordination altered. Significant differences (P<0.05) were additionally observed in muscle oxygenation during pre-intervention for participant one (t(46) = 30.985, p>0.05), four (t(60) = 24.680, p<0.05) and five (t(60) = -62.024, p<0.05) indicating higher tissue oxygenation in the paretic limb.
Conclusion: The initial findings of this research suggest that an eBike intervention can induce improvements in individuals who have suffered a stroke. The intervention encouraged the participants to become more physically active and demonstrated that eBike application can be successful in supporting and overcoming some stroke comorbidities. The results of this study give preliminary evidence in support of eBikes to increase activity after stroke and warrants further research.