Aerobic Responses to FES-Assisted and Volitional Cycling in Children with Cerebral Palsy.

Ashwini Sansare,Ahad Behboodi,Henry Wright,Samuel C K Lee,Ann Tokay Harrington,Khushboo Verma,James Alesi

doi:10.3390/s21227590

Abstract

Recumbent stationary cycling is a potential exercise modality for individuals with cerebral palsy (CP) that lack the postural control needed for upright exercises. Functional electrical stimulation (FES) of lower extremity muscles can help such individuals reach the cycling intensities that are required for aerobic benefits. The aim of this study was to examine the effect of cycling with and without FES assistance to that of a no-intervention control group on the cardiorespiratory fitness of children with CP. Thirty-nine participants were randomized to a FES group that underwent an 8-week FES-assisted cycling program, the volitional group (VOL), who cycled without FES, or a no-intervention control group (CON) (15 FES, 11 VOL, 13 CON). Cadence, peak VO2, and net rise in heart rate were assessed at baseline, end of training, and washout (8-weeks after cessation of training). Latent growth curve modeling was used for analysis. The FES group showed significantly higher cycling cadences than the VOL and CON groups at POST and WO. There were no differences in improvements in the peak VO2 and peak net HR between groups. FES-assisted cycling may help children with CP attain higher cycling cadences and to retain these gains after training cessation. Higher training intensities may be necessary to obtain improvements in peak VO2 and heart rate.

Highlights

Published: 15 November 2021Individuals with cerebral palsy (CP) present with reduced muscle strength, muscle tone abnormalities, co-contraction of agonist and antagonist muscles, and poor selective voluntary motor control [1,2]
Thirty-nine participants enrolled in the study (15 Functional electrical stimulation (FES), 11 volitional group (VOL), 13 control group (CON))
For all three outcome measures across all time points, covariance was not statistically significant, indicating that the initial level of the cadence, peak VO2, and heart rate (HR) was not related to the rate of change in these measures. This randomized control trial (RCT) investigated the benefits of FES-assisted cycling and volitional cycling over a no-intervention control group on cardiorespiratory fitness in children with CP over an

Summary

Introduction

Individuals with cerebral palsy (CP) present with reduced muscle strength, muscle tone abnormalities, co-contraction of agonist and antagonist muscles, and poor selective voluntary motor control [1,2]. These aforementioned impairments result in poor motor performance and reduced mobility in children with CP. As children with CP enter adolescence and adulthood, there is a decline in independence, limited participation in physical activities and sports, and poor cardiorespiratory fitness compared to their peers [3,4,5]. Abnormal muscle tone and motor activation, may prevent individuals with CP from attaining cycling cadences and heart rates required to produce aerobic benefits.

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