Positive effects of functional electrical stimulation-assisted cycling on perception of effort, cerebral blood flow and cognition in post-stroke patients
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Objective
To test the effect of functional electrical stimulation-assisted cycling on stroke patients’ perception of effort (primary aim), cerebral blood flow, and cognitive performance (exploratory aims).
Design
Randomized controlled study.
Subjects/Patients
Fifteen post-stroke patients completed functional electrical stimulation-assisted and traditional cycling sessions separated by 72h.
Methods
Perceived effort, cardio, and cerebrovascular parameters were monitored during exercise. Cognitive performance was assessed before and after each session. Qualitative data were reported after both sessions.
Results
Patients reported a lower perceived effort during functional electrical stimulation-assisted cycling than traditional cycling. Both sessions increased heart rate, end-tidal CO 2 , cardiac output, and cerebral artery blood flow velocity, with higher blood lactate levels after functional electrical stimulation-assisted cycling. Functional electrical stimulation-assisted cycling positively impacted cognitive performance.
Conclusion
Traditional and functional electrical stimulation-assisted cycling induced similar increased cardio and cerebrovascular responses. However, patients perceived functional electrical stimulation-assisted cycling as less effortful than traditional cycling. As effort is a barrier to regular exercise engagement and adherence, these results are promising for implementing functional electrical stimulation-assisted cycling in stroke patients’ rehabilitation.
Lay Abstract
This study explored whether cycling assisted by functional electrical stimulation (FES) could make exercise easier for people who have had a stroke, while also providing benefits to the brain. Fifteen stroke survivors completed two cycling sessions, one with FES and one without, spaced 72 hours apart. We measured perceived effort, cardiovascular and cerebral responses during exercise, as well as cognitive performance before and after each session. Patients reported that FES-assisted cycling felt less difficult and less tiring than traditional cycling, even though both sessions triggered similar heart and brain blood flow responses. Cognitive performance also improved more after the FES-assisted session. Since perceived effort is often a major barrier to rehabilitation after stroke, these findings suggest that FES-assisted cycling could promote better engagement in physical activity and support recovery.
