title: Neuro-Mechanics of Recumbent Leg Cycling in Post-Acute Stroke Patients.
abstract: Cycling training is strongly applied in post-stroke rehabilitation, but how its modular control is altered soon after stroke has been not analyzed yet. EMG signals from 9 leg muscles and pedal forces were measured bilaterally during recumbent pedaling in 16 post-acute stroke patients and 12 age-matched healthy controls. Patients were asked to walk over a GaitRite mat and standard gait parameters were computed. Four muscle synergies were extracted through nonnegative matrix factorization in healthy subjects and patients unaffected legs. Two to four synergies were identified in the affected sides and the number of synergies significantly correlated with the Motricity Index (Spearman's coefficient = 0.521). The reduced coordination complexity resulted in a reduced biomechanical performance, with the two-module sub-group showing the lowest work production and mechanical effectiveness in the affected side. These patients also exhibited locomotor impairments (reduced gait speed, asymmetrical stance time, prolonged double support time). Significant correlations were found between cycling-based metrics and gait parameters, suggesting that neuro-mechanical quantities of pedaling can inform on walking dysfunctions. Our findings support the use of pedaling as a rehabilitation method and an assessment tool after stroke, mainly in the early phase, when patients can be unable to perform a safe and active gait training.
authors.affiliation: Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.|Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Salvatore Maugeri Foundation, Institute of Care and Research (IRCCS), Lissone, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Ambrosini
authors.affiliation: BioLab3, Department of Engineering, University Roma TRE, Rome, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: De Marchis
authors.affiliation: Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pedrocchi
authors.affiliation: Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ferrigno
authors.affiliation: Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Salvatore Maugeri Foundation, Institute of Care and Research (IRCCS), Lissone, Italy.|Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Monticone
authors.affiliation: BioLab3, Department of Engineering, University Roma TRE, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Schmid
authors.affiliation: BioLab3, Department of Engineering, University Roma TRE, Rome, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: D'Alessio
authors.affiliation: BioLab3, Department of Engineering, University Roma TRE, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Conforto
authors.affiliation: Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy. simona.ferrante@polimi.it.|Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Salvatore Maugeri Foundation, Institute of Care and Research (IRCCS), Lissone, Italy. simona.ferrante@polimi.it.
authors.forename: Simona
authors.initials: S
authors.lastname: Ferrante
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001259:Ataxia / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D020521:Stroke / Q000503:physiopathology*; D016138:Walking
keywords: Biomechanics; Electromyography; Hemiparesis; Motor control; Muscle synergies; Pedaling