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 

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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.

Walking ability and functional status after post-acute care for stroke rehabilitation in different age groups: a prospective study based on propensity score matching

Improved is NOT GOOD ENOUGH. The goal is 100% recovery. What followup research will be done to get there?

Walking ability and functional status after post-acute care for stroke rehabilitation in different age groups: a prospective study based on propensity score matching

Wang CY¹,

Miyoshi S²,

Chen CH³,

Lee KC¹,

Chang LC⁴,

Chung JH⁵,

Shi HY⁵

Author information

Aging, 31 May 2020, 12
DOI: 10.18632/aging.103288 PMID: 32482912 

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Abstract 

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Few studies have compared how rehabilitative post-acute care affects recovery of walking ability and other functions after stroke in different age groups. After propensity score matching (1:1), 316 stroke patients were separated into an aged group (age ≥65 years, n=158) and a non-aged group (age <65 years, n=158). Both groups significantly improved in Barthel index, EuroQol-5 dimension, Berg balance scale, 6-minute walking distance and 5-meter walking speed (P<0.001). The non-aged group had significantly larger improvements in Berg balance scale, instrumental activities of daily living, EuroQol-5 dimension and 6-minute walking distance (P<0.001) compared to the aged group. The two groups did not significantly differ in Barthel index, 5-meter walking speed, length of stay, and cost. The aged group had poorer walking ability and poorer instrumental activities of daily living compared to the non-aged group. After intensive rehabilitative post-acute care, however, the aged group improved in walking ability, functional performance and mental health. Intensive strength training for unaffected lower limbs in the stroke patients achieved good recovery of walking ability and other functions. Overall, intensive rehabilitative post-acute care improved self-care ability and decreased informal care costs. Rehabilitative PAC under per-diem reimbursement is efficient and economical for stroke patients in an aging society.

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