PTOTRCTAmerican journal of physical medicine & rehabilitation2025

Forced-Rate Aerobic Cycling Improves Locomotor Function and Gait Biomechanics in Individuals With Chronic Stroke: A Randomized Controlled Trial.

Susan M Linder, Ryan Rilinger, Ken Learman and 8 others

PMID 40720308

WHAT IT FOUND

Forced-rate aerobic cycling combined with upper extremity task practice did not significantly improve treadmill gait speed compared to task practice alone.

However, the cycling group showed significant gains in overground walking distance and specific gait mechanics like paretic step length and hip power.

Key findings

01The primary outcome of comfortable gait velocity on a treadmill showed no significant difference between the cycling group and the control group.

02Participants who performed forced-rate cycling improved their 6-minute walk test distance by 53.3 meters, compared to 15.6 meters for the control group.

03The cycling group demonstrated significant improvements in paretic step length and total paretic limb hip, knee, and ankle power compared to controls.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The primary aim of the larger trial was upper extremity recovery, so participant selection criteria did not account for the degree of gait impairment. Gait velocity was measured on a treadmill, which may not fully reflect overground walking patterns. The study did not use electromyography to confirm changes in muscle activation patterns. Participants were allowed to use ankle-foot orthoses and handrails during gait testing, though this was consistent within individuals across time points.

Declared interests

Author Jay Alberts declares a conflict of interest related to intellectual property for the motorized cycle used in the trial.

The easy way to misread this

Do not conclude that forced-rate cycling is superior to standard care for improving gait speed. The primary outcome of treadmill gait velocity was not significantly different between groups, and the observed benefits were specific to overground walking capacity and certain biomechanical parameters.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →