The effects of cycling on walking outcomes in adults with stroke: a systematic review

Top Stroke Rehabil. 2024 Apr;31(3):259-271. doi: 10.1080/10749357.2023.2259167. Epub 2023 Sep 21.

Abstract

Background: Stationary cycling is often prescribed for survivors of stroke as a safe means of aerobic exercise to improve cardiovascular health. While cycling is typically not prescribed to restore ambulatory function, improvements in measures of walking after cycling interventions have been reported in the literature.

Objective: To investigate the effects of cycling on walking outcomes in adults with stroke.

Methods: Relevant databases were searched through 15 August. Walking-related outcomes were extracted. Correlation coefficients were computed to measure the relationship between exercise protocol parameters and change in walking outcomes.

Results: Eleven articles were included in the review. Eight studies representing nine cycling intervention groups reported change in walking capacity measured by the six-minute walk test with improvements ranging from 6.1 to 63.0 m. Seven studies measured gait velocity, reporting improvements ranging from 0.01 to 0.21 m/sec. Protocols that yielded the greatest improvement in walking capacity prescribed moderate- to high-intensity aerobic training. Significant positive correlations were measured between change in gait velocity and number of exercise sessions and total minutes of exercise prescribed.

Conclusion: Considerable heterogeneity was observed across cycling protocols with respect to intensity, frequency, exercise duration and protocol duration. However, none of the studies reported declines in walking outcomes and improvements were measured in the absence of task-specific gait training. Cycling interventions employing moderate- to high-intensity aerobic training and 24 sessions or more may be optimal in improving gait velocity and walking capacity.

Keywords: Aerobic; cycling; gait; locomotion; walking.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Adult
  • Exercise
  • Exercise Therapy / methods
  • Humans
  • Stroke Rehabilitation* / methods
  • Stroke* / complications
  • Stroke* / therapy
  • Walking