Beneficial effects of eight weeks of FES-assisted cycling on aerobic capacity and paretic quadriceps thickness in post-stroke hemiparesis

 'Improved' IS STILL FAILURE! It means your competent? doctor and hospital has lots more work to do to get to 100% recovery! Make sure you DEMAND 100% RECOVERY PROTOCOLS from your doctor! Nothing less!

Beneficial effects of eight weeks of FES-assisted cycling on aerobic capacity and paretic quadriceps thickness in post-stroke hemiparesis

• Maël Descollonges,
• Julie Di Marco,
• Pierre-Henri Pouillart,
• Ehsan Jafari,
• Lana Popović-Maneski,
• Ana Z. Radić,
• Olivera C. Djordjević,
• Ljubica M. Konstantinović,
• Sindi Z. Mitrović,
• Julien V. Brugniaux &
• Gaëlle Deley 

• 43 Accesses

• Explore all metrics

We’re sharing this article early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply.

Abstract

Background

Stroke is a leading cause of long-term disability worldwide, frequently impairing walking ability, postural control, and muscle strength. Hemiparesis, affecting nearly 90% of stroke survivors, results in unilateral motor deficits and presents substantial rehabilitation challenges. Functional electrical stimulation-assisted cycling (FES-assisted cycling) has shown potential to activate paretic muscles, improve aerobic capacity, and enhance motor coordination.

Objective

This study aimed to compare the effects of an 8-week FES-assisted cycling program (Kurage, Lyon, France) versus traditional cycling (without stimulation) on aerobic fitness, muscle thickness, and walking performance in post-stroke participants.

Methods

This randomized study included 31 post-stroke participants (21 men, 10 women; age: 57 ± 12 years), who were randomly assigned to either an FES-assisted cycling group or a conventional cycling group. Both groups completed 24 cycling sessions (30 min each) over 8 weeks, in addition to standard rehabilitation. Outcomes included peak oxygen uptake (V̇O₂peak), maximal power output, muscle thickness (rectus femoris and vastus intermedius), and walking ability (6-Minute and 10-Meter Walk Tests).

Results

Both groups showed significant improvements in V̇O₂peak, power output, muscle thickness, and walking test performance. The FES group showed greater gains in V̇O₂peak (+ 27% vs. +12% in the control group; P = 0.038) and in paretic muscle thickness (rectus femoris: +17% vs. +3%, P = 0.036; vastus intermedius: +24.6% vs. +7%, P = 0.029). A trend toward greater improvement in the 6-Minute Walk Test was also observed in the FES group (+ 43% vs. +25%; P = 0.082).

Conclusion

FES-assisted and traditional cycling improved exercise capacity, muscle thickness, and walking ability in post-stroke participants. FES-assisted cycling led to additional benefits specifically for V̇O₂peak and localized hypertrophy in the paretic muscles targeted by FES, suggesting specific neuromuscular adaptations that are not commonly described in previous studies. These peripheral changes indicate that FES-assisted cycling may offer unique muscular benefits, particularly for individuals with limited voluntary control. These findings refine our understanding of FES as a complementary tool in stroke rehabilitation. Further research with larger cohorts and longer follow-up is needed to confirm these effects and assess long-term outcomes.

Column: Dr Watkins On Brain Health & More

 I bet your doctor is so incompetent that NO PROTOCOL HAS BEEN CREATED ON BDNF! Let's check how long incompetence reigned and still not fired!

BDNF (214 posts to April 2011)

Column: Dr Watkins On Brain Health & More

[Column written by Dr Kimberley Watkins]

Over the past few weeks we’ve looked at cardiovascular disease and at stroke and rehabilitation. This week we zoom in on a tiny protein with a mighty job in your brain, and one that exercise helps boost: BDNF.

Why exercise matters for the brain

Exercise is famous for helping your heart, your waistline and your mood. But your brain gets a share of the benefits too. Studies link regular activity with sharper memory, a better mood and a lower risk of stroke and dementia. Physical inactivity as one of 14 risk factors we can actually do something about.

What is BDNF?

BDNF stands for brain-derived neurotrophic factor. Think of it as fertilizer for your brain cells. It helps them grow, stay healthy and form new connections with each other. That ability to build and rewire connections is called neuroplasticity. It’s why you can learn new things, and it’s why rehabilitation after a brain injury can work. Higher BDNF levels are linked to better learning and memory.

Neuroplasticity: the brain building and strengthening connections. Amber lines show new pathways forming.

The exercise-BDNF connection

Did you know that moving your body can help keep your brain healthy? When you exercise, your brain makes more of a special protein that helps your brain cells grow and stay strong. Think of it like plant food, but for your brain.

But not all exercise works the same way. Activities that make you breathe harder, like brisk walking, jogging, or cycling, seem to help your brain the most. In one study, just 30 minutes of hard bike riding made a big difference, while easy riding didn’t. In another study, older adults who walked regularly for a year grew the part of their brain that supports memory, while those who only stretched saw it shrink a little. The more of this brain-boosting protein people had, the bigger the benefits.

This is good news for people recovering from a stroke, too. Studies show that more intense exercise, like brisk walking or cycling can boost this protein and may help the brain heal and adapt, which is a key part of recovery.(Your doctors' responsibility to get you recovered enough to do this!)

The bottom line: regular, heart-pumping exercise is not just good for your body, it’s great for your brain, too!

Good for your brain, and for everything else

Scientists are still working out exactly how much of the BDNF boost turns into better memory or recovery, and it varies from person to person. But you don’t have to wait for the final answer. Exercise already comes with a long list of proven benefits, for your heart, your mood, your energy and your risk of stroke and dementia, and the evidence suggests your brain is part of that same package.

Practical takeaways

• Start with a conversation. Talk to your doctor or physiotherapist before you begin, especially if you’ve had a stroke or heart condition, or haven’t exercised in a while. Ask questions until you feel comfortable and confident about what’s safe and right for you.
• Aim for 150 minutes a week. The World Health Organization recommends at least 150 minutes of moderate activity like brisk walking [about 30 minutes, five days a week], or 75 minutes of vigorous activity. Some exercise is always better than none.
• Turn up the effort gradually. The research favours getting your heart rate up. Build toward a pace where chatting gets difficult.
• Be consistent. Do something every day, and make it something you enjoy. You’re far more likely to keep doing it.
• Mix it up. Aerobic exercise has the strongest BDNF evidence, and the WHO also recommends regular muscle-strengthening activity for all ages.

The bottom line

Exercise does far more than build a stronger body. It supports the organ that makes you who you are: your memory, your mood, your ability to learn, adapt and recover. BDNF is one exciting piece of that story, and scientists are still uncovering more. But the message is already clear: what’s good for your body is good for your brain. Better still, there’s no wrong time to start.

So how do you keep moving as life changes, from childhood through to your later years? Join us next time for Move More at Every Age, where we’ll share simple ways to stay active at every stage of life, with tips to improve your health along the way.

- Dr Kimberley Watkins

New study reveals cycling can reduce dementia risk by 88%

 Ask your competent? doctor EXACTLY HOW TO GET CYCLING AGAIN! Can't do that; your doctor is incompetent!  My doctor never asked me what sports I did; that was an obvious sign of incompetence; not knowing what the patient wanted to return to! I can't do a bicycle anymore with a useless left arm/hand, my balance is off and mentally I can't do it anymore. So, I bought a recumbent tricycle.

This is why you need this; to prevent your post stroke dementia, has your doctor even told you of the risk?

Your risk of dementia, has your doctor told you of this?  Your doctor is responsible for preventing this! Is s/he willing to get you recovered enough to do this?

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018 

New study reveals cycling can reduce dementia risk by 88%

Forget running and swimming, this workout is best for your brain

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Getting older is inevitable, but there’s been a host of studies that prove regular exercise is one of the best ways to future-proof your health.

Data shows that women make up two thirds of dementia cases globally, with the loss of estrogen during menopause increasing the risk of the most common types of dementia. Yet a 44-year study, published in the journal Neurology, has linked cycling to long-term brain protection.

What the study shows

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The study looked at a sample of 1462 women aged 38 to 60. At the start of the study, between 1968-1970, 191 of the women completed a maximal cycling test on a stationary bike. They performed various cycling intervals, cycling at a low intensity, and increasing the intensity every few minutes until they reached exhaustion.

Their peak workload achieved at exhaustion was recorded. This was measured in watts, and researchers used it as a marker for their maximal cardiovascular fitness level.

The researchers concluded that high fitness delayed the age of dementia onset by 9.5 years, and that the women who demonstrated high cardio fitness had an 88% lower risk of developing dementia.

The women in the study were then examined for signs of dementia in 1974, 1980, 2000, 2005, and 2009. This included neuropsychiatric examinations, interviews with the women, and hospital records. The researchers also looked at socioeconomic factors, like income and education, as well as the women’s diets, smoking habits, and any existing illnesses.

The results showed that only 5% of the highly fit women, based on the scores in the cycling tests at the beginning of the study, developed dementia, compared to 32% in the moderate group. The researchers concluded that high fitness delayed the age of dementia onset by 9.5 years, and that the women who demonstrated high cardio fitness had an 88% lower risk of developing dementia.

How to get started with cycling

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If you’re not into cycling, or you don’t have the space to install one of the best exercise bikes in your home, don’t panic. Building cardiovascular fitness can be achieved through swimming, running, and even fast walking, so it’s not just biking that holds memory-boosting benefits.