title: After-effects of pedaling exercise on spinal excitability and spinal reciprocal inhibition in patients with chronic stroke.
abstract: OBJECTIVE
  To evaluate the after-effects of pedaling on spinal excitability and spinal reciprocal inhibition in patients with post-stroke spastic hemiparesis.
  
  
  METHODS
  Twenty stroke patients with severe hemiparesis participated in this study and were instructed to perform 7 min of active pedaling and 7 min of passive pedaling with a recumbent ergometer at a comfortable speed. H reflexes and M waves of paretic soleus muscles were recorded at rest before, immediately after and 30 min after active and passive pedaling. The Hmax/Mmax ratio and H recruitment curve were measured. Reciprocal inhibition was assessed using the soleus H reflex conditioning test paradigm.
  
  
  RESULTS
  The Hmax/Mmax ratio was significantly decreased after active and passive pedaling exercise. The decreased Hmax/Mmax ratio after active pedaling lasted at least for 30 min. The H recruitment curve and reciprocal inhibition did not change significantly after active or passive pedaling exercise.
  
  
  CONCLUSIONS
  Pedaling exercise decreased spinal excitability in patients with severe hemiparesis. Pedaling may be effective in rehabilitation following stroke.
authors.affiliation: a Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan.|b Division of Rehabilitation Medicine , Shizuoka Cancer Center , Shizuoka , Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tanuma
authors.affiliation: c Department of Rehabilitation Medicine , Tokai University School of Medicine , Isehara , Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fujiwara
authors.affiliation: a Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: d Department of Rehabilitation , Asahikawa Medical University , Asahikawa , Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Ro
authors.affiliation: e Seisen Orthopedic Clinic , Tokyo , Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Arano
authors.affiliation: f Center for Information and Neural Networks, National Institute of Information and Communications Technology , Osaka , Japan.|g Japan Society for Promotion of Science , Tokyo , Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Uehara
authors.affiliation: a Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Honaga
authors.affiliation: a Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Mukaino
authors.affiliation: a Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Kimura
authors.affiliation: a Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan.
authors.forename: Meigen
authors.initials: M
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D001642:Bicycling; D004558:Electric Stimulation; D004576:Electromyography; D016552:Ergometry; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006181:H-Reflex / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D013116:Spinal Cord / Q000502:physiology*; D020521:Stroke / Q000150:complications / Q000628:therapy*
keywords: H reflex; ergometry; muscle spasticity; rehabilitation; stroke