New technology to address affected vs nonaffected arm contributions to ergometer performance in people poststroke

ABSTRACT

Background

When pedaling a coupled-crank arm ergometer, individuals with hemiplegia may experience nonparetic arm overcompensation, and paretic arm resistance, due to neuromechanical deficits. Technologies that foster independent limb contributions may increase the effectiveness of exercise for people poststroke.

Objective

Examine the speed during uncoupled pedaling with the Advanced Virtual Exercise Environment Device among individuals poststroke and non-impaired comparisons.

Methods

We recruited 2 groups:Poststroke and Comparison. Participants attended one lab session and performed peak speed tests and a graded exercise repeated for bilateral pedaling, unilateral (left, right).

Results

Thirty-one participants completed the protocol (16 women, 15 men). Poststroke participants pedaled slower during the bilateral speed test (64 ± 39 RPM, p < .001), and graded exercise, (54 ± 28 RPM, p < .001) versus comparisons (141 ± 19, 104 ± 12 RPM). Poststroke individuals had lower peak RPM during the unilateral speed test with their paretic arm (70 ± 46 RPM, p < .001) and graded exercise (58 ± 33 RPM, p < .001) compared to their unilateral speed test (130 ± 37 RPM) and graded exercise (108 ± 25 RPM) with their nonparetic arm. Comparisons did not differ between arms during speed tests and graded exercise. Poststroke participants demonstrated lower peak speed with their affected arm during the bilateral speed test (52 ± 42 RPM, p < .001) and graded exercise (49 ± 28 RPM, p = .008) compared to the same arm during unilateral speed (70 ± 46 RPM) and graded exercise (58 ± 33 RPM).

Conclusions

Poststroke participants pedaled faster with their affected arm unilaterally versus bilateral pedaling, suggesting interhemispheric interference that reduces the ability to recruit the paretic arm during bilateral exercise.

KEYWORDS:

• Poststroke rehabilitation
• arm ergometry
• interhemispheric inhibition
• physical disability
• neurorehabilitation
• upper extremity hemiparesis

Acknowledgments

We would like to acknowledge Lloyd Cooper and Foster Phillips of Push Product Design for designing the AVEED and Jake Davis, and Amy Belcher for their contributions throughout the testing phases.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Geoloc¯ation information

This study was conducted in Birmingham, Alabama within the United States of America.

Additional information

Funding

This work was supported under RERC RecTech funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90REGE0002).