Abstract
Cycling exercise is commonly used in rehabilitation to improve lower extremity (LE) motor function and gait performance after stroke. Motor learning is important for regaining motor skills, suggesting that training of motor skills influences cortical plasticity. However, the effects of motor skill learning in dynamic alternating movements of both legs on cortical plasticity remain unclear. Here, we examined the effects of skillful cycling training on cortical plasticity of the LE motor area in healthy adults. Eleven healthy volunteers participated in the following three sessions on different days: skillful cycling training, constant-speed cycling training, and rest condition. Skillful cycling training required the navigation of a marker up and down curves by controlling the rotation speed of the pedals. Participants were instructed to fit the marker to the target curves as accurately as possible. Amplitudes of motor evoked potentials (MEPs) and short-interval intracortical inhibition (SICI) evoked using transcranial magnetic stimulation (TMS) were assessed at baseline, after every 10 min of the task (a total of 30 min), and 30 min after the third and final trial. A decrease in tracking errors was representative of the formation of motor learning following skillful cycling training. Compared to baseline, SICI was significantly decreased after skillful cycling training in the tibialis anterior (TA) muscle. The task-induced alterations of SICI were more prominent and lasted longer with skillful cycling training than with the other conditions. The changes in SICI were negatively correlated with a change in tracking error ratio at 20 min the task. MEP amplitudes were not significantly altered with any condition. In conclusion, skillful cycling training induced long-lasting plastic changes of intracortical inhibition, which corresponded to the learning process in the LE motor cortex. These findings suggest that skillful cycling training would be an effective LE rehabilitation method after stroke.
Highlights
Motor impairments following stroke remain one of the leading causes of long-term disability in daily life (Miller et al, 2010; Lee and Cho, 2017)
We examined the effects of a cycling motor task which incorporates skillful tracking via the adjustment of rotational speed on cortical plasticity using paired-pulse transcranial magnetic stimulation (TMS)
At T30 and T60, shortinterval intracortical inhibition (SICI) for skillful cycling training was significantly decreased compared to that for constant-speed cycling training (T30: Cohen’s d = 1.236, power = 0.788; T60: Cohen’s d = 1.000, power = 0.607). These results suggest that cycling training induced sustained plastic changes in the primary motor cortex, and that these changes were more profound in the skillful cycling than the constant-speed cycling training
Summary
Motor impairments following stroke remain one of the leading causes of long-term disability in daily life (Miller et al, 2010; Lee and Cho, 2017). Neurophysiological studies have reported the changes of H-reflex, reciprocal inhibition and shortinterval intracortical inhibition (SICI) after cycling exercise in healthy persons (Mazzocchio et al, 2006; Yamaguchi et al, 2012, 2013) and patients with stroke (Tanuma et al, 2017). These studies suggest that cycling exercise may induce neural plasticity which contributes to functional recovery in the LE. The relationship between neural mechanisms that enhance cortical plasticity of the LE and motor learning of bipedal performance is unclear
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