Effectiveness of Active Cycling in Subacute Stroke Rehabilitation: A Randomized Controlled Trial

Published:March 08, 2017DOI:



      To examine the effects of 3 months of aerobic training (AT) followed by coaching on aerobic capacity, strength, and gait speed after subacute stroke.


      Randomized controlled trial.


      Inpatient rehabilitation center.


      Patients (N=59; mean age ± SD, 65.4±10.3y; 21 women (36%); Barthel Index ≤50 in 64% of patients) with first stroke and able to cycle at 50 revolutions/min were enrolled in the study 3 to 10 weeks after stroke onset.


      Patients were randomly allocated to a 3-month active cycling group (ACG, n=33) and education, or to a control group (CG, n=26). Afterward, patients in the ACG were randomly assigned either to a coaching (n=15) or to a noncoaching group (n=16) for 9 months.

      Main Outcome Measures

      Aerobic capacity, isometric knee extension strength, and gait ability and speed were measured before and after intervention and during follow-up at 6 and 12 months.


      A nonsignificant difference was found in workload (Wattpeak) (P=.078) between ACG and CG after 3 months. Furthermore, after 3 months of cycling and after 9 months of coaching, all groups showed significant changes over time (P≤.027) in peak oxygen consumption, Wattpeak, leg strength, and gait speed. Also, significant changes over time (P<.001) were found in the ACG and the CG in patients with walking inability at baseline.


      No significant differences between training groups were found over time. Although our study did not have objective exercise data from the training device during follow-up, the 3-month active cycling (AC) program combined with education sessions seemed an applicable method in subacute stroke rehabilitation. New long-term AT interventions should focus on coaching approaches to facilitate training after a supervised AC program.


      List of abbreviations:

      AC (active cycling), ACG (active cycling group), ADL (activities of daily living), AT (aerobic training), CG (control group), Co-ACG (active cycling group with coaching), FAC (Functional Ambulation Category), Nco-ACG (active cycling group without coaching), RMA-GF (Rivermead Motor Assessment Gross Function Scale), Vo2peak (peak oxygen consumption), Wattpeak (last fulfilled increment in workload during the maximal graded exercise test)
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