{"title":"Biomechanical and neuromuscular outcomes during cycling help inform lower limb sensorimotor function after stroke: A systematic review","authors":"Julie Soulard , Roua Walha , Cyril Duclos , Dahlia Kairy , Claudine Auger , Sylvie Nadeau","doi":"10.1016/j.rehab.2025.101955","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Pedalling on a bicycle is an appropriate rehabilitation intervention which brings complementary information on strength, smoothness, accuracy, and coordination at the lower limbs during movement. This systematic review aims to identify how biomechanical and neuromuscular cycling outcomes inform lower limb sensorimotor function after stroke and to quantify their level of association with clinical measurements.</div></div><div><h3>Methods</h3><div>The Medline, EMBASE, and CINAHL databases were searched using keywords related to stroke, cycling, and lower limb assessment. The search included original peer-reviewed articles from inception to July 2024 involving adults after stroke for whom cycling was used to evaluate lower limb sensorimotor function. Search, article selection, and data extraction were done by 2 independent reviewers. The risk of bias was assessed with a modified Downs and Black checklist.</div></div><div><h3>Results</h3><div>Fifty-nine articles were included in the review (1290 individuals) with methodological quality ranging from very low 7 % to very high 88 %. High methodological heterogeneity among the articles was observed in cycling modalities and protocols. The articles included >100 different cycling outcomes which can be grouped into kinetic, kinematic, and neuromuscular categories. Psychometric properties of the cycling outcomes were rarely documented (3 articles). Twelve articles reported moderate to very strong significant associations (correlation coefficient values >0.6) of kinetic cycling outcomes with gait (<em>n</em> = 10), balance (<em>n</em> = 6), motricity (<em>n</em> = 8), of kinematic cycling outcomes with motricity (<em>n</em> = 2), and of muscular cycling outcomes with balance (<em>n</em> = 1), and motricity (<em>n</em> = 13).</div></div><div><h3>Conclusion</h3><div>The review supports that pedalling on a bicycle provides relevant cycling outcomes which could be useful to complement clinical evaluation in physical rehabilitation. Several kinetic, kinematic, and neuromuscular cycling outcomes are well correlated to lower limb sensorimotor function in individuals after stroke. However, the protocols and clinimetric properties of cycling outcomes require future work.</div></div><div><h3>Trial registration</h3><div>PROSPERO: CRD42022342113.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 5","pages":"Article 101955"},"PeriodicalIF":3.9000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Physical and Rehabilitation Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S187706572500020X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Pedalling on a bicycle is an appropriate rehabilitation intervention which brings complementary information on strength, smoothness, accuracy, and coordination at the lower limbs during movement. This systematic review aims to identify how biomechanical and neuromuscular cycling outcomes inform lower limb sensorimotor function after stroke and to quantify their level of association with clinical measurements.
Methods
The Medline, EMBASE, and CINAHL databases were searched using keywords related to stroke, cycling, and lower limb assessment. The search included original peer-reviewed articles from inception to July 2024 involving adults after stroke for whom cycling was used to evaluate lower limb sensorimotor function. Search, article selection, and data extraction were done by 2 independent reviewers. The risk of bias was assessed with a modified Downs and Black checklist.
Results
Fifty-nine articles were included in the review (1290 individuals) with methodological quality ranging from very low 7 % to very high 88 %. High methodological heterogeneity among the articles was observed in cycling modalities and protocols. The articles included >100 different cycling outcomes which can be grouped into kinetic, kinematic, and neuromuscular categories. Psychometric properties of the cycling outcomes were rarely documented (3 articles). Twelve articles reported moderate to very strong significant associations (correlation coefficient values >0.6) of kinetic cycling outcomes with gait (n = 10), balance (n = 6), motricity (n = 8), of kinematic cycling outcomes with motricity (n = 2), and of muscular cycling outcomes with balance (n = 1), and motricity (n = 13).
Conclusion
The review supports that pedalling on a bicycle provides relevant cycling outcomes which could be useful to complement clinical evaluation in physical rehabilitation. Several kinetic, kinematic, and neuromuscular cycling outcomes are well correlated to lower limb sensorimotor function in individuals after stroke. However, the protocols and clinimetric properties of cycling outcomes require future work.
期刊介绍：
Annals of Physical and Rehabilitation Medicine covers all areas of Rehabilitation and Physical Medicine; such as: methods of evaluation of motor, sensory, cognitive and visceral impairments; acute and chronic musculoskeletal disorders and pain; disabilities in adult and children ; processes of rehabilitation in orthopaedic, rhumatological, neurological, cardiovascular, pulmonary and urological diseases.
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