Biomechanics of recumbent cycling in adolescents with cerebral palsy with and without the use of a fixed shank guide.
New stationary cycles can decrease motion in the frontal and transverse planes with a shank guide. However, there are no studies comparing cycling with and without this guide. The purpose of this study was to compare cycling with and without a shank guide for adolescents with cerebral palsy (CP). Three males and seven females (15.6+/-1.8 years) with CP, classified as levels III and IV with the Gross Motor Functional Classification System, underwent biomechanical analysis of stationary recumbent cycling with and without a shank guide at 30 and 60 rpm if able. Data collected included three-dimensional lower extremity joint kinematics using motion analysis, surface electromyography of eight lower extremity muscles, cocontraction of six agonist/antagonist pairings, efficiency (power output divided by oxygen consumption), and perceived exertion (OMNI Scale of Perceived Exertion). Non-circular data were analyzed via ANOVAs, and circular data were analyzed using circular t-tests. The shank guide altered joint kinematics in all three planes (p<0.008), had a minor impact on muscle activity (p<0.006), and had no impact on cocontraction (p>0.008), efficiency (p=0.920), or perceived exertion (p=0.318). The results suggest that a shank guide during cycling may be beneficial for individuals with CP to decrease the amount of hip and knee frontal and transverse plane motion. Knee movement in these planes has been associated with pain in healthy adults; therefore the guide may help to prevent long-term complications from cycling for adolescents with CP.
Johnston
Therese E
TE
Shriners Hospitals for Children, 3551 North Broad Street, Philadelphia, PA 19140, United States. tjohnston@shrinenet.org
Barr
Ann E
AE
Lee
Samuel C K
SC
D000293:Adolescent; D000704:Analysis of Variance; D001642:Bicycling / Q000502:physiology*; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000503:physiopathology*; D004576:Electromyography; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D007866:Leg / Q000503:physiopathology*; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology; D010101:Oxygen Consumption / Q000502:physiology
Res Q Exerc Sport. 2004 Dec;75(4):361-9
15673035
J Neurophysiol. 2003 May;89(5):2396-405
12611935
Gait Posture. 1998 Dec 1;8(3):163-174
10200406
Electroencephalogr Clin Neurophysiol. 1996 Dec;101(6):511-9
9020824
Phys Ther. 1987 Jan;67(1):43-8
3797476
Scand J Rehabil Med. 1985;17(2):53-61
4023660
Med Sci Sports Exerc. 2001 Jan;33(1):117-22
11194096
Dev Med Child Neurol. 1997 Apr;39(4):214-23
9183258
J Biomech. 2003 Jun;36(6):803-13
12742448
Med Sci Sports. 1977 Summer;9(2):113-7
895427
Dev Med Child Neurol. 2002 Mar;44(3):205-11
12005323
J Pediatr Orthop. 2005 Jan-Feb;25(1):79-83
15614065
Scand J Rehabil Med. 1988;20(1):35-41
3413453
J Neurophysiol. 1999 Aug;82(2):515-25
10444651
Med Sci Sports Exerc. 2000 Feb;32(2):493-8
10694137
J Biomech. 1986;19(9):683-94
3793743
Spinal Cord. 2005 Sep;43(9):543-9
15838528
Acta Paediatr Suppl. 1996 Oct;416:58-62
8997450
Dev Med Child Neurol. 2002 Mar;44(3):148-57
12005315
Phys Ther. 2007 May;87(5):572-85
17405804