Passive cycling in neurorehabilitation after spinal cord injury: A review

The Journal of Spinal Cord Medicine, 2017 · DOI: 10.1080/10790268.2016.1248524 · Published: January 1, 2017

Spinal Cord Injury Neurorehabilitation Rehabilitation

Simple Explanation

Passive cycling (PC) is explored as a neurorehabilitation option for patients too weak or unstable for active movement. This review examines animal and human studies on PC after spinal cord injury (SCI). Animal studies suggest PC can modulate spinal reflexes, reduce spasticity and autonomic dysreflexia, and elicit cardio-protective effects, potentially increasing neurotrophic factors. Human studies, however, have not consistently shown these benefits. While PC shows promise, current evidence is limited. Further research is needed to understand if PC can activate cortical structures and improve motor performance in SCI patients.

Study Duration

Not specified

Participants

Animal and human studies

Evidence Level

Review

Key Findings

1
In animal models, passive cycling modulated spinal reflexes and reduced spasticity.
2
Animal studies showed that PC can reduce autonomic dysreflexia and elicit cardio-protective effects.
3
Human studies have not consistently shown an effect of PC on spasticity reduction or prevention of cardiovascular complications.

Research Summary

This review examines passive cycling (PC) as a neurorehabilitation program for patients with spinal cord injury (SCI), particularly those unable to perform active movements. Experimental studies in animals suggest PC has positive effects on spinal reflexes, spasticity, autonomic dysreflexia, and cardio-metabolic responses. PC also increased levels of mRNA for certain neurotrophic factors. Human studies have not consistently demonstrated the same benefits, and the evidence to support PC as a standard treatment for SCI patients is still limited. Further research is needed to explore its potential to activate cortical structures and improve motor performance.

Practical Implications

Potential Therapeutic Intervention

PC may serve as a low-cost therapeutic intervention with potential motor, sensory, and cardiovascular benefits for SCI patients.

Further Research Needed

Carefully designed prospective studies are needed to fully understand the impact of PC on cortical structures and motor performance.

Early Intervention Strategy

PC does not require volitional motor control and can thus be initiated early after SCI.

Study Limitations

1
Limited evidence to support PC as a standard treatment.
2
Heterogeneity in injury severity and outcome measures across studies.
3
Lack of translational studies in humans, with most evidence from rodent models.

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