Pedaling Exercise Research Articles

Effects of unilateral and bilateral lower extremity fatigue on static stance and postural adjustments response to the externally initiated perturbation

The study investigated the effects of unilateral and bilateral lower extremity fatigue on both postural stability and postural adjustments. Fourteen young male subjects performed unilateral and bilateral dynamic lower extremity pedaling exercises with 5 sets of 20 times at 50 % maximum voluntary contraction. Center of pressure (COP) signals were recorded before and after the fatigue exercise. Electromyography activities of six trunk and leg muscles were recorded and analyzed during the anticipatory (APAs) and compensatory (CPAs) postural adjustments. The results showed that both fatiguing exercises caused an increase in COP and larger APAs and CPAs in the rectus femoris and tibialis anterior during externally initiated perturbation. However, the observed indicators showed no clear difference between unilateral and bilateral fatigue. These results validated that when enlarged APAs were not sufficient to resist the external perturbation, the central nervous system increased the strength of CPAs to maintain the stability of the body. These findings provided a perspective on the association between APAs and CPAs, which may apply to the athletic training or rehabilitation on postural control.

Latest Topics of Beneficial Pedaling Exercise for Knee Osteoarthritis (OA) and the Elderly from Anti-Aging Perspective

Latest Topics of Beneficial Pedaling Exercise for Knee Osteoarthritis (OA) and the Elderly from Anti-Aging Perspective

Interval Versus Continuous Intradialytic Training on Muscle Quality Index and Functional Capacity in Hemodialysis Patients: a Prospective Randomized Clinical Study

INTRODUCTION. Chronic kidney disease (CKD) is an important health well-being problem globally, with increasing incidence. That tends to create an “epidemic”. Generalized muscle weakness in hemodialysis patients typically affects the lower limbs and proximal muscles. Patients experience impaired endurance and quality of life. Exercise is prescribed for these individuals to improve their physical health and prevent disease consequences. AIM. To find out the effect of interval versus continuous intradialytic training on muscle quality index and functional capacity in Hemodialysis patients. MATERIALS AND METHODS. Sixty men with chronic renal insufficiency grade 5 on hemodialysis aged from 45 to 55 years were divided into two groups using computerized block randomization: Groups (A) and (B) each containing 30 patients. They underwent 8-week program of high intensity interval training (HIIT), moderate intensity continuous training (MICT) intradialytic pedaling exercise plus hemodialysis three times per week. Pre-test and post-test evaluations have been carried out for 6-minute walk test (6MWT) and muscle quality index (MQI) of all patients. RESULTS. Both groups had a significant positive improvement in MQI and 6MWT with different proportions, patients received high intensity interval intradialytic pedaling exercise had a slightly significant improvement in MQI compared to moderate intensity continuous training group. While, moderate intensity training group had a more significant improvement in 6MWT compared to high intensity training group. CONCLUSION. Both HIIT and MICT are realistic and good options for individuals with CKD and have parallel profits on functional capability and, skeletal muscle quality and overall quality of life.

Experimental validation of an advanced impedance pneumography for monitoring ventilation volume during programmed cycling exercise

Objective. Impedance pneumography (IP) has provided static assessments of subjects’ breathing patterns in previous studies. Evaluating the feasibility and limitation of ambulatory IP based respiratory monitoring needs further investigation on clinically relevant exercise designs. The aim of this study was to evaluate the capacity of an advanced IP in ambulatory respiratory monitoring, and its predictive value in independent ventilatory capacity quantification during cardiopulmonary exercise testing (CPET). Approach. 35 volunteers were examined with the same calibration methodology and CPET exercise protocol comprising phases of rest, unloaded, incremental load, maximum load, recovery and further-recovery. In 3 or 4 deep breaths of calibration stage, thoracic impedance and criterion spirometric volume were simultaneously recorded to produce phase-specific prior calibration coefficients (CCs). The IP measurement during exercise protocol was converted by prior CCs to volume estimation curve and thus calculate minute ventilation (VE) independent from the spirometry approach. Main results. Across all measurements, the relative error of IP-derived VE (VER) and flowrate-derived VE (VEf) was less than 13.8%. In Bland-Altman plots, the aggregate VE estimation bias was statistically insignificant for all 3 phases with pedaling exercise and the discrepancy between VER and VEf fell within the 95% limits of agreement (95% LoA) for 34 or all subjects in each of all CPET phases. Significance. This work reinforces the independent use of IP as an accurate and robust alternative to flowmeter for applications in cycle ergometry CPET, which could significantly encourage the clinical use of IP and improve the convenience and comfort of CPET.

Efficacy of pulmonary telerehabilitation on exercise tolerance, fatigue, perceived exertion, depression, and quality of life in COVID-19 survivors

INTRODUCTION: Telerehabilitation advanced significantly with the emergence of COVID-19 and the recommendation of limiting physiotherapist-patient contact time whenever practicable. The effectiveness of telerehabilitation on those who had a longer stay in hospital and on oxygen support following discharge is still under question. OBJECTIVES: To evaluate the effects after six weeks of pulmonary telerehabilitation on exercise tolerance, fatigue level, perceived exertion, symptoms of depression and quality of life in patients surviving COVID-19. MATERIALS AND METHODS: A quasi-experimental study was conducted on 25 post-COVID-19 patients following discharge in a home environment setting. The participants were advised to prepare equipment such as oxygen concentrator, B-type oxygen cylinder (backup), lengthy oxygen tubes, finger pulse oximeter, mini static pedal exerciser, incentive spirometry, weight cuffs or water bottles and sandbags. After six weeks of telerehabilitation, the patients underwent assessments including initial oxygen saturation (SPO2), heart rate, peak oxygen demand during exercise to maintain baseline SPO2, peak heart rate, maximum drop in SPO2, recovery time to baseline SPO2 measured with a pulse oximeter and stopwatch, peak perceived exertion using the Borg Dyspnea Scale, peak fatigue score using the visual analog scale (VASF), quality of life assessed with the SF-36 questionnaire, and mental health status evaluated with the Hamilton Depression Scale (HAMD). One-way repeated measure ANOVA and paired t-test were used. RESULTS: Significant improvements following the intervention on the initial SPO2 (F (2.12, 23.13) = 21.0, p<0.05) and heart rate (F (1.839, 20.23) = 43.73, p<0.05), peak maximum oxygen demand during exercise to maintain baseline SPO2 (F (1.487, 16.36) = 8.96, p<0.05), peak maximum perceived exertion (F (5, 55) = 112.51, p<0.05), peak maximum fatigue score (F (1.755, 19.30) = 67.44, p<0.05), peak heart rate (F (1.798, 19.78) = 50.99, p<0.05), peak drop in SPO2 (F (2.467, 27.14) = 41.46, p<0.05) and peak recovery time to achieve baseline SPO2 (F (5, 55) = 78.89, p<0.05). Six-week post-analysis on the depressive symptoms (mean difference =11.25, p< 0.05) and quality of life also showed significant improvement (mean difference =29.92, p< 0.05). CONCLUSION: Six weeks of comprehensive pulmonary telerehabilitation with simple equipment improved tolerance to exercise, fatigue, perceived exertion, symptoms of depression and quality of life for post-COVID-19 patients.

Piloting the effectiveness of the Workout on Wheels Internet Intervention (WOWii) program among individuals with mobility disabilities

BackgroundDoing any amount of moderate-to-vigorous physical activity yields health benefits. Individuals with mobility disabilities are among the least physically active Americans and limited evidence indicates effective strategies to promote physical activity among this group. ObjectiveExamine whether a 16-week virtual intervention program (Workout on Wheels internet intervention, WOWii) increases exercise engagement among mobility impaired individuals. MethodsParticipants recruited through community organizations that provide services to individuals with disabilities. The WOWii program is comprised of 3 core components: 16 weeks of virtual intervention delivery and access to the WOWii website; staff and peer support; an exercise package that included an activity tracker and heart rate monitor, pedal exerciser, and therabands. ResultsTen people enrolled. Participants demonstrated good program engagement, attending an average of 14.1 ± 2.1 of the 16 virtual meetings and completing an average of 10.6 ± 5.6 weekly activities. Exercise data revealed that participants increased their time spent in aerobic exercise from an average of two days a week performing 32 ± 22 min during week one to an average of five days a week doing 127 ± 143 min in the final WOWii week. Only half continued to exercise over the two months once WOWii virtual meetings ended. ConclusionWOWii program delivery successfully promoted increased exercise participation for people with mobility disabilities over the 16 intervention weeks. Future studies should investigate approaches to promote exercise maintenance beyond program delivery.

Aerobic physical exercise versus dual-task cognitive walking in cognitive rehabilitation of people with stroke: a randomized clinical trial.

Stroke is a neurological deficit caused by an acute focal injury to the central nervous system due to vascular injury that can result in loss of neurological function, lasting brain damage, long-term disability and, in some cases, death. The literature reports that aerobic physical exercise, as well as dual-task cognitive walking, are used for the cognitive recovery of people with stroke. We aimed to assess whether aerobic physical exercise influences post-stroke cognitive recovery, namely performance on selective and sustained attention. We tested the hypothesis that post-stroke aerobic physical exercise leads to more significant gains than post-stroke dual-task cognitive walking. We used a Randomized Clinical Trial, single-blind, parallel group, to verify the existence of differences between two groups. A total of 34 patients with subacute to chronic stroke were divided into two groups to train three times a week for 12 weeks: the aerobic physical exercise (PE) group engaged in 20 min on a treadmill, 20 min on a stationary bicycle and 5 min on a desk bike pedal exerciser per session; the dual-task (DT) gait exercise group walked for 45 min while simultaneously performing cognitive tasks per session. All participants were assessed on cognitive functioning with the Mini-Mental State Examination (MMSE) and d2 Test of Attention before acute interventions and post interventions. We have also applied a Visual Analog Scale to monitor the participants' perceived difficulty, pre-, post-acute, and post-chronic interventions. Participants also responded to a Borg Scale of perceived exertion following the acute and the final session of chronic training. A mixed model ANOVA revealed a significant interaction effect with a large effect size for most of the cognitive variables under study. The variables associated with the d2 Test of Attention showed significant differences between the groups, mainly from T0 to T2. Also for MMSE, an ANOVA revealed a significant interaction effect with significant improvements from T0 to T2. Our results strongly suggest that aerobic physical exercise is more beneficial than dual-task cognitive-gait exercise since in the PE group, cognitive attention scores increase, and cognitive impairment and perception of exertion decrease, compared to the DT group. These findings support that PE provides more significant benefits for patients post-stroke when compared to DT.

Power production strategy during steady-state cycling is cadence dependent

Crank power is produced by extension and flexion of the hip and knee joints during steady-state pedaling below 120 rpm. Despite the pedaling cadence exceeding 120 rpm during track cycling, the power production strategy for lower-limb coordination above 120 rpm is unknown. This study aimed to assess the effects of various pedaling cadences on the power production strategy of lower-limb coordination during steady-state pedaling. Twenty trained collegiate cyclists performed a 30-s steady-state pedaling exercise at 50% of maximal anaerobic power under four different conditions with 90-, 120-, 150- and 180-rpm pedaling cadences. Pedal kinetics and limb kinematics were recorded using a pedal force measurement system and motion capture system, respectively. Positive mechanical work of hip extension significantly decreased with increasing pedaling cadence (P < 0.05). In contrast, the positive mechanical work of the knee joint flexion significantly increased with increasing pedaling cadence (P < 0.05). For contribution to the total mechanical work at 150 or above rpm, the knee joint showed > 70% of the total contribution, whereas the hip joint showed < 40%. Additionally, the positive mechanical work of the hip shifted to negative mechanical work under 180-rpm condition. These results indicate that power production strategy during steady-state pedaling at 180 rpm is different from the general pedaling cadence. Therefore, specific training needs to be conducted at an excessive-high pedaling cadence such as 180 rpm to achieve high performance in track cycling.

ACE-I/D Allele Modulates Improvements of Cardiorespiratory Function and Muscle Performance with Interval-Type Exercise.

Background: The prominent insertion/deletion polymorphism in the gene for the major modulator of tissue perfusion, angiotensin-converting enzyme (ACE-I/D) is associated with variability in adjustments in cardiac and skeletal muscle performance with standard forms of endurance and strength type training. Here, we tested whether the ACE-I/D genotype would be associated with variability in the effects of interval-type training on peak and aerobic performance of peripheral muscle and cardio-vasculature and post-exercise recovery. Methods: Nine healthy subjects (39.0 ± 14.7 years of age; 64.6 ± 16.1 kg, 173.6 ± 9.9) completed eight weeks of interval training on a soft robotic device based on repeated sets of a pedaling exercise at a matched intensity relative to their peak aerobic power output. Prior to and post-training, peak anaerobic and aerobic power output was assessed, mechanical work and metabolic stress (oxygen saturation and hemoglobin concentrations of Musculus vastus lateralis (VAS) and Musculus gastrocnemius (GAS), blood lactate and factors setting cardiac output such as heart rate, systolic and diastolic blood pressure were monitored during ramp-incremental exercise and interval exercise with the calculation of areas under the curve (AUC), which were put in relation to the produced muscle work. Genotyping was performed based on I- and D-allele-specific polymerase chain reactions on genomic DNA from mucosal swaps. The significance of interaction effects between training and ACE I-allele on absolute and work-related values was assessed with repeated measures ANOVA. Results: Subjects delivered 87% more muscle work/power, 106% more cardiac output, and muscles experienced ~72% more of a deficit in oxygen saturation and a ~35% higher passage of total hemoglobin during single interval exercise after the eight weeks of training. Interval training affected aspects of skeletal muscle metabolism and performance, whose variability was associated with the ACE I-allele. This concerned the economically favorable alterations in the work-related AUC for the deficit of SmO2 in the VAS and GAS muscles during the ramp exercise for the I-allele carriers and opposing deteriorations in non-carriers. Conversely, oxygen saturation in the VAS and GAS at rest and during interval exercise was selectively improved after training for the non-carriers of the I-allele when the AUC of tHb per work during interval exercise deteriorated in the carriers. Training also improved aerobic peak power output by 4% in the carriers but not the non-carriers (p = 0.772) of the ACE I-allele while reducing negative peak power (-27.0%) to a lesser extent in the ACE I-allele carriers than the non-carriers. Variability in cardiac parameters (i.e., the AUC of heart rate and glucose during ramp exercise, was similar to the time to recovery of maximal tHb in both muscles after cessation of ramp exercise, only associated with the ACE I-allele but not training per se. Diastolic blood pressure and cardiac output during recovery from exhaustive ramp exercise demonstrated a trend for training-associated differences in association with the ACE I-allele. Discussion: The exercise-type dependent manifestation of antidromic adjustments in leg muscle perfusion and associated local aerobic metabolism between carriers and non-carriers of the ACE I-allele with the interval-training highlight that non-carriers of the I-allele do not present an essential handicap to improve perfusion-related aerobic muscle metabolism but that the manifestation of responsiveness depends on the produced work. Conclusions: The deployed interval-type of exercise produced ACE I-allele-related differences in the alterations of negative anaerobic performance and perfusion-related aerobic muscle metabolism, which manifestation is exercise specific. The training-invariant ACE I-allele-associated differences in heart rate and blood glucose concentration emphasize that the repeated impact of the interval stimulus, despite a near doubling of the initial metabolic load, was insufficient to overturn ACE-related genetic influences on cardiovascular function.

PedaleoVR: Usability study of a virtual reality application for cycling exercise in patients with lower limb disorders and elderly people.

Achieving adherence to physical exercise training is essential in elders and adults with neurological disorders. Immersive technologies are seeing wide adoption among new neurorehabilitation therapies, as they provide a highly effective motivational and stimulating component. The aim of this study is to verify whether the developed virtual reality system for pedaling exercise is accepted and could be safety, useful and motivating for these populations. A feasibility study was conducted with patients with neuromotor disorders and elderly people from Lescer Clinic and the residential group Albertia, respectively. All the participants performed a pedaling exercise session with virtual reality platform. Then, the Intrinsic Motivation Inventory, the System Usability Scale (SUS), Credibility and Expectancy Questionnaire, were assessed in the group of 20 adults (mean age = 61.1; standard deviation = 12.617, 15 males and 5 females) with lower limb disorders. While the Simulator Sickness Questionnaire, Presence Questionnaire, Game user Experience Satisfaction Scale and SUS were assessed in the group of 18 elders (mean age = 85.16; standard deviation = 5.93, 5 males and 13 females). In light of the outcomes, PedaleoVR is considered to be a credible, usable and motivational tool towards adults with neuromotor disorders to perform cycling exercise, and therefore its usage could contribute to adherence to lower limb training activities. Moreover, PedaleoVR does not generate negative effects related to cybersickness while the sensation of presence and the degree of satisfaction generated have been positively evaluated by the geriatric population. This trial has been registered at ClinicalTrials.gov under the identifier: NCT05162040, Dec 2021.

Constant Load Pedaling Exercise Combined with Electrical Muscle Stimulation Leads to an Early Increase in Sweat Lactate Levels.

A novel exercise modality combined with electrical muscle stimulation (EMS) has been reported to increase cardiovascular and metabolic responses, such as blood lactate concentration. We aimed to examine the effect of constant load pedaling exercise, combined with EMS, by non-invasively and continuously measuring sweat lactate levels. A total of 22 healthy young men (20.7 ± 0.8 years) performed a constant load pedaling exercise for 20 min at 125% of the pre-measured ventilatory work threshold with (EMS condition) and without (control condition) EMS stimulation. Blood lactate concentration was measured by blood samples obtained from the earlobe every minute. Sweat lactate was monitored in real time using a sensor placed on the forearm. The sweat lactate threshold (sLT) was defined as the point of increase in sweat lactate. sLT occurred significantly earlier in the EMS condition than in the control condition. In the single regression analysis, the difference in sLT between the two conditions, as the independent variable, was a significant predictor of the difference in blood lactate concentrations at the end of the exercise (p < 0.05, r = −0.52). Sweat lactate measurement may be a noninvasive and simple alternative to blood lactate measurement to determine the effectiveness of exercise combined with EMS.

Effects Of Electrical Muscle Stimulation With Voluntary Pedaling Exercise On Skeletal Muscle Morphology And Function

PURPOSE: This study was to examine the effects of EMS while voluntary pedaling exercise for 8 weeks on the morphology and function of skeletal muscles. METHODS: Fifteen college age students (19-24) were randomly divided into EMS group; EMS only (n = 7) and EMS-EX group; EMS with voluntary pedaling (n = 8). They completed EMS training for 8 weeks (two times per weeks). The EMS group was performed EMS in a seated position, and the EMS-EX group was performed EMS with voluntary pedaling at 40-50 rpm with a very low load (0.5% of body weight) for 20 minutes, respectively. EMS was applied to the quadriceps muscle with the stimulator. The stimulator current waveform was set at a frequency of 50 Hz with a pulse width of 250 μs for both groups. Also, the stimulation intensity (mA) was set to the maximum intensity (23 to 60 mA) that they could tolerate for each session. We measured knee extension isometric and isokinetic strength (angular velocity60,120,180 deg/s), muscular endurance as skeletal muscle function, rectus femoris muscle thickness and thigh circumference as skeletal muscle morphology before and after 8 weeks of training. Each parameter was statistical analyzed by paired t-test were completed to identify any significant between-groups (p < 0.05). RESULTS: Knee extension isometric and isokinetic strength tended to increase after EMS training in both groups. But there was no difference in the changes between the two groups, the rate of increase in muscle strength in the EMS-EX group tended to be higher than that in the EMS group. Total work capacity and first 1/3 work capacity as muscular endurance were significantly increased in both groups(p < 0.05), but final 1/3 work capacity increased only in the EMS-EX group(EMS group; 99.3 ± 12.0%, EMS-EX group; 103.4 ± 9.5%) after EMS training. Rectus femoris muscle thickness of both group were significantly increased after EMS training (EMS group; 112.3 ± 5.6% and EMS-EX group; 111.7 ± 11.7%, p < 0.05). And thigh circumference in EMS-EX group was significantly increased after EMS training (p < 0.05). CONCLUSIONS: These results suggest that EMS would be induce increased isometric and isokinetic muscle strength and muscle hypertrophy. Furthermore, EMS training while voluntarily pedaling may be more effective than EMS alone in improving morphology and function of skeletal muscle.

MO1054: Development of Home Dialysis Patient Support System Using Cloud System II––Addition of Exercise Therapy Function

BACKGROUND AND AIMSThe number of patients requiring home dialysis in Japan is increasing due to COVID-19 and the aging of the population. Home haemodialysis has been performed in Japan since the 1960s. However, as of March 2019, there were 720 home haemodialysis patients in Japan, which is only 0.2% of the total number of dialysis patients. The possible causes are as follows.The number of home haemodialysis patients has not increased markedly due to safety concerns as home haemodialysis patients perform dialysis at home, and the out-of-pocket costs are high. In addition, patients and caregivers must be able to manage themselves, and the burden on both patients and caregivers is heavy. Therefore, the Ministry of Health, Labour and Welfare (Japan) has advocated the need for home patients to share information with medical institutions to improve their quality of life, including COVID-19 measures. We have built a system to support home dialysis patients. Here, we have added an exercise therapy function to this system to encourage patients to continue exercising.METHOD The items recorded/displayed in the patient's home peritoneal dialysis support system included records such as time, blood pressure, blood glucose level, urine volume, meal content, replacement start time, dialysate/plasma ratio, drainage volume, injection volume, water content and water removal and drainage. These inputs were entered via drop-down menus and displayed visually in graphs or by uploading images. The medical staff could see photographs of the affected areas and of meals entered by the patient. Patients could also share their opinions and treatment schedules with the medical staff at the medical institution. In addition, when exercising, the patients used an ergometer that allowed them to sit or lie down. The developed system incorporates records of the patient's exercises. Data were captured directly from the ergometer into the developed system in CSV format and could also be entered manually via drop-down menus.RESULTSUsing the developed system, we were able to enter and view patients’ vital data and display photographs showing the color and volume of the drainage pack. By viewing these photographs, the medical staff could confirm the photographs of the affected areas, the color of the packs and the contents of the patients’ meals. In addition, displaying the patient's vital records in a graph allowed for visual evaluation over time, which was useful when giving advice to patients. Using the two-way communication function, patients were also able to share their opinions and treatment schedules with the medical staff of the medical institution. Patients can now consult with medical staff, making their homes more like part of the hospital and giving them greater peace of mind.Figure 1 shows an example of the display of the developed system. Figure 2 shows an example of the patient's pedaling exercise results input from the ergometer. The amount of pedal movement performed by the patient was conserved through the dynamo and used to charge mobile devices. This allows the patient to charge their mobile devices while exercising, thus encouraging them to continue exercising.CONCLUSION We have developed a support system for home haemodialysis patients that allows the input and display of patients’ vital records and consultation with medical staff online. We have added a function to the system to encourage home haemodialysis patients to continue exercising. By using the developed system, patients can now perform home dialysis, including continuous exercise safely and with peace of mind, and healthcare professionals can access all medical information of patients, including changes over time.This research was supported in part by Gakushin Kaken (JP18K19710, JP20H03982).

Changes in the skin characteristics associated with dehydration and rehydration

ABSTRACT The present study aimed to test the hypothesis that changes in the dermal tissue dielectric constant (TDC) and biomechanical properties of the skin would be correlated with the indicators related to dehydration. Ten healthy adult men were enrolled in three trials: no fluid intake (DEH), ad libitum fluid intake (AL-HYD), and programmed fluid intake (P-HYD) after exercise in a randomised crossover design. The participants performed a pedalling exercise at 60% heart rate reserve until 2% body mass loss. At 120 min after exercise, an incremental exercise test was carried out. Aerobic capacity, body composition, TDC, biomechanical properties of the skin (pliability, viscoelasticity, and total recovery), and indicators related to dehydration in the serum and urine were measured before and 120 min after exercise. Higher values of the pliability and viscoelasticity, and lower value of the total recovery on the hand were demonstrated in the P-HYD trial compared to the DEH trial (all P < 0.05). Changes in the TDC were significantly correlated with changes in body mass, total body water, serum osmolarity, and hematocrit (all P < 0.05). Changes in the biomechanical properties of the hand were significantly correlated with changes in body mass, hematocrit, and urine specific gravity (all P < 0.05). The present study showed that the changes in skin characteristics correlated with the body water and dehydration-associated indicators in the serum and urine, thus suggesting that skin characteristics may be useful in the assessment of dehydration. Highlights This study was the first to investigate the effect of dehydration and rehydration on the TDC and biomechanical properties of the skin upon instrumental measure, and not manual testing. This study confirmed the decline in aerobic capacity by dehydration and immediate recovery with sufficient rehydration. Changes in the TDC and the biomechanical properties of the skin correlated with the body water and dehydration-associated indicators in the serum and urine. Skin characteristics may be useful in the assessment of dehydration.

Brain Connectivity Changes During Bimanual and Rotated Motor Imagery.

Motor imagery-based brain-computer interface (MI-BCI) currently represents a new trend in rehabilitation. However, individual differences in the responsive frequency bands and a poor understanding of the communication between the ipsilesional motor areas and other regions limit the use of MI-BCI therapy. Objective: Bimanual training has recently attracted attention as it achieves better outcomes as compared to repetitive one-handed training. This study compared the effects of three MI tasks with different visual feedback. Methods: Fourteen healthy subjects performed single hand motor imagery tasks while watching single static hand (traditional MI), single hand with rotation movement (rmMI), and bimanual coordination with a hand pedal exerciser (bcMI). Functional connectivity is estimated by Transfer Entropy (TE) analysis for brain information flow. Results: Brain connectivity of conducting three MI tasks showed that the bcMI demonstrated increased communications from the parietal to the bilateral prefrontal areas and increased contralateral connections between motor-related zones and spatial processing regions. Discussion/Conclusion: The results revealed bimanual coordination operation events increased spatial information and motor planning under the motor imagery task. And the proposed bimanual coordination MI-BCI (bcMI-BCI) can also achieve the effect of traditional motor imagery tasks and promotes more effective connections with different brain regions to better integrate motor-cortex functions for aiding the development of more effective MI-BCI therapy. Clinical and Translational Impact Statement The proposed bcMI-BCI provides more effective connections with different brain areas and integrates motor-cortex functions to promote motor imagery rehabilitation for patients’ impairment.

Investigating the Immediate Influence of Moderate Pedal Exercises during an Assembly Work on Performance and Workload in Healthy Men.

Physical inactivity has increased in prevalence among adults in industrialized and developing countries owing to the fact that the majority of job situations require individuals to remain seated for extended periods of time. This research aims to evaluate the influence of cycling on a stationary bike while executing a keyboard assembly task on the task completion time, error percentage, and physiological and subjective measurements. The physiological measures were electroencephalography (EEG) and electrocardiographic (ECG) signal responses, whereas the subjective measures were subjective workload ratings and subjective body discomforts. Two variables were evaluated, namely assembly methods (with versus without pedal exercises at a moderate intensity) and session testing (pre- versus post-test). Thus, the repeated measures design (i.e., assembly method by session testing of participants) was used. According to the completion time, error %, participant self-reports, and ECG and EEG statistical analysis data, the participants’ performances in the keyboard assembly task did not decrease while they performed pedaling exercises (p > 0.05). Additionally, when participants completed the assembly task while executing the pedaling exercises, the mean inter-beat (RR) intervals significantly reduced (p < 0.05) while the mean heart rate increased (p < 0.05), which mean that pedaling exercises caused physical workloads on the participants. Participant performance was unaffected by performing a workout while performing the assembly activity. Thus, administrations should encourage their employees to engage in short sessions of moderate-intensity exercise similar to the suggested exercise in the study to improve a person’s physical health during work without interfering with the effectiveness of work.

A Comparative Study on Instantaneous and Mean Pulse Arrival Time for Cuffless Blood Pressure Estimation

Pulse arrival time (PAT) is the delay time between the peak of the R-wave Electrocardiogram (ECG) signal and the peak of Photoplethysmogram (PPG) signals. This method is widely exploited for continuous cuffless blood pressure measurement. In the literature, the PAT was determined based on the mean at a certain number or certain period of heartbeats, but none of them deployed a single pulse wave for PAT calculation. Therefore, in this paper, a relationship between mean PAT (15 pulses ± Standard Deviation (SD)) and instantaneous PAT (a pulse) with blood pressure (BP) was investigated on thirteen healthy male volunteers (aged between 17 to 42 years) through a pedal exercise. The PAT is grouped into three (3) categories which depend on the spatial position of the PPG signal measured; finger (PATf), wrist (PATw), and underfoot (PATt). The ECG and the PPG signals were synchronized using a Nexus-10 MK II data acquisition device and Matlab software (R 2014b) for subsequent analysis. An oscillometric cuff-based blood pressure instrument (Ostar, P2) was used as a BP reference during the experiment. Statistical analysis showed no significant difference in the |r| value between mean (15 pulses ± SD) and instantaneous PAT-BP; hence both methods are applicable for BP estimation using the PAT-BP calibration technique.

Effect of revascularization on lower extremity muscle function in combined type 2 diabetes and critical limb threatening ischemia.

Critical limb-threatening ischemia (CLTI) and type 2 diabetes (T2D) frequently co-exist and often with less favorable outcome after revascularization. The objective was to evaluate the effects of revascularization on muscle function, perfusion and mitochondrial respiration in patients with combined CLTI and T2D. A prospective translational observational study. Two groups of patients facing unilateral peripheral revascularization was included: Patients suffering from combined disease with CLTI+T2D (N.=14) and patients suffering from CLTI (N.=15). During pedal exercise testing, calf muscle perfusion was monitored with near-infrared spectroscopy (NIRS) and leg arterial volume flow in the common femoral artery with duplex ultrasound. Calf muscle biopsy and subsequent assessment of mitochondrial respiratory capacity on isolated muscle fibers was performed. Tests was performed before and six weeks after revascularization. After revascularization, patients CLTI+T2D improved in muscle force from 8.48 kg (CI: 7.49-9.46) to 13.11 kg (CI: 11.58-14.63), (P<0.001). Conversely, muscle force in patients suffering from non-diabetic CLTI decreased from 10.03 kg (CI: 9.1-10.96) to 9.73 kg (CI: 8.77-10.69), (P=0.042). Muscle oxygenation during exercise improved more in the CLTI+T2D group (6.36 µM/kg/s [CI: 5.71-7.01] compared to 2.11 µM/kg/s [CI:1.38-2.83] in the CLTI group; P=0.002). No improvement or difference between groups regarding mitochondrial function was detected. Patients with combined CLTI+T2D, had an unsuspected better effect of revascularization compared to patients with non-diabetic CLTI, in terms of increased muscle force and improved muscle perfusion. Further studies are needed to elucidate the apparent interaction of the CLTI and T2D syndromes.

A Single Bout of Constant-Load Exercise Test for Estimating the Time Constant of Oxygen Uptake Kinetics in Individuals With Stroke.

Objective To examine the relationship between the time constant of oxygen uptake kinetics during the onset of exercise (τVO2) estimated from a single exercise bout and that obtained from three averaged exercise bouts in individuals with stroke.MethodsTwenty participants with stroke performed three bouts of a constant-load pedaling exercise at approximately 80% of the workload corresponding to the ventilatory threshold to estimate τVO2. The VO2 data from the first trial of three bouts were used to estimate τVO2 for a single bout. Additionally, data collected from three bouts were ensemble-averaged to obtain τVO2 for three averaged bouts as the criterion.ResultsThere was a very high correlation between τVO2 for a single bout (34.8±14.0 seconds) and τVO2 for three averaged bouts (38.5±13.4 seconds) (r=0.926, p<0.001). However, τVO2 for a single bout was smaller than that for three averaged bouts (p=0.006).ConclusionτVO2 for a single bout could reflect the relative difference in τVO2 for three averaged bouts among individuals with stroke. However, it should be noted that τVO2 for a single bout may be underestimated compared to τVO2 for three averaged bouts.

The Effect of Real-Time Video-Based Engagement and Feedback during Pedaling on Cadence Control and Exercise Motivation: A Proof-of-Concept Study.

The use of video and music as an intrinsic, dissociative attentional stimulus during exercise is thought to distract from the physical discomfort of exercise, and contribute to improved exercise adherence; however, the effects of video-based feedback and engagement during pedaling on exercise performance and motivation are poorly understood. The aims of the present study were twofold. Firstly, to develop a novel video-based engagement regime for pedaling that links pedaling cadence with the play rate of a video, and secondly, to employ an instrumented pedaling device to assess the influence of the video engagement paradigm on cadence performance and exercise motivation. Eighteen healthy subjects participated in 15-min-duration pedaling sessions while targeting a specific low cadence (60 rotations per minute) and high cadence (100 rotations per minute), including pedaling with the provision of (i) target pedaling cadence information only, (ii) visual feedback on cadence control, including pedaling duration, pedaling cadence, and cadence deviation from target, and (iii) real-time engagement, which involved pedaling at the target speed to maintain the playback rate of a pre-recorded video. Cadence deviation from the target was evaluated, and self-reported exercise motivation examined with a post-exercise survey. Pedaling-cadence deviations significantly reduced with cadence feedback at both low and high cadence (p < 0.05). Participants reported enjoying feedback and video-based engagement during pedaling, with 83% of participants feeling that engagement motivated them to perform pedaling-based exercise. In conclusion, real-time cadence control feedback and video-based engagement during pedaling for healthy individuals may improve performance in targeted pedaling tasks. Through dissociation from the physical cues associated with exercise and fatigue, feedback and engagement may ultimately increase enjoyment and exercise compliance and adherence of pedaling-based exercise. The findings may be useful in prescription and maintenance of targeted pedaling exercises for stroke rehabilitation and exercise therapy.