Home‑based arm cycling exercise improves trunk control in persons with incomplete spinal cord injury: an observational study

Scientific Reports, 2023 · DOI: 10.1038/s41598-023-49053-w · Published: December 4, 2023

Spinal Cord Injury Neuroplasticity Rehabilitation

Simple Explanation

This study investigates if arm cycling can improve trunk control in people with incomplete spinal cord injury (SCI). Arm cycling is often used for heart and lung rehab, but its effect on trunk control after SCI isn't well-known. The study had two parts: one looked at how a single arm cycling session affected the connection between the brain and trunk muscles. The second part examined if a 6-week home arm cycling program could improve trunk control. The findings suggest arm cycling can indeed improve trunk function in individuals with SCI. This could offer a simple, at-home rehab method to improve stability and movement after spinal cord injuries.

Study Duration

6 weeks (Experiment 2)

Participants

15 individuals with SCI and 15 able-bodied controls (Experiment 1); 11 participants with SCI (Experiment 2)

Evidence Level

Observational study

Key Findings

1
A single arm cycling session increased the excitability of the corticospinal pathway to the erector spinae (ES) muscle in both SCI and able-bodied individuals.
2
Six weeks of home-based arm cycling exercise training improved forward reaching distance and trunk control during rapid shoulder flexion in individuals with SCI.
3
The improvements in trunk control were accompanied by increased ES muscle activity and corticospinal excitability, suggesting a change in neuromuscular control.

Research Summary

The study investigated the effects of arm cycling exercise on trunk control in individuals with incomplete SCI. Experiment 1 demonstrated increased corticospinal excitability of the ES muscle after a single arm cycling session in both SCI and able-bodied participants. Experiment 2 showed that a 6-week home-based arm cycling exercise training improved forward reaching distance and trunk control during rapid shoulder flexion in individuals with SCI. The findings suggest that arm cycling exercise can be a feasible and effective method for trunk rehabilitation in individuals with SCI, potentially engaging the corticospinal pathway projecting to the trunk muscles.

Practical Implications

Home-Based Rehabilitation

Arm cycling can be implemented as a low-cost, unsupervised home-based rehabilitation strategy for individuals with SCI to improve trunk control and functional reaching.

Neuromuscular Engagement

Arm cycling exercise may engage the corticospinal pathway projecting to the trunk muscles, promoting neuroplasticity and improving neuromuscular control of the trunk.

Improved Functional Outcomes

Regular arm cycling exercise can lead to improvements in functional tasks such as forward reaching and rapid shoulder flexion, enhancing the ability to perform daily activities.

Study Limitations

1
Age and sex differences between groups in Experiment 1 could have influenced MEP amplitudes.
2
Small sample size in Experiment 2 may limit the generalizability of the functional outcome results.
3
Recordings obtained on different days (pre- and post-assessment) may introduce between-session variability to the EMG amplitudes.

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