Spasticity - Can cycling help?

Spasticity or muscle spasms are experienced by many individuals who have had a spinal cord injury.  When there is spasticity, there is always paresis or plegia.  And spasticity leads to  muscle atrophy (weakening) caused by immobility.  Although the damage to the upper motor neurons is irreversible, the act of cycling -  combining a motorised ergometer and stimulator such as the RehaMove systems, can be effective in reducing spasticity.

Spasticity leads to muscle shortening, contractures and fundamental changes in muscle structure.  Because cycling demands coordinated motion of both limbs and all of the limb joints as well as periods of muscle contraction and stretching, this activity seems to dampen down a tendency toward spasticity.  At first, cycling may not be possible as a fluent, smooth activity. Spasticity may tend to block motion so the RehaMove system has built-in systems to manage this occurence.

Built into the ergometer is a control system that when combined with FES provides a method of managing spasticity based upon gradual improvements in flexibility, strength and biofeedback.

Now stretching is a well known physiotherapy intervention.  Stretching is used to maintain a joint's full range of motion and it can prevent muscle shortening and contractures.  Practice suggests that passive stretching has to be applied for two hours per day to prevent contractures.  This is beyond most physiotherapy practice.  Research on muscle performance suggest that the effects of physiotherpay on muscle tone only last approximately 30 minutes.

Using FES Cycling helps to work the limbs through a useful range of motion and strengthen the muscles.  The RehaMove system is smart in that it is designed to adapt to the user's particular situation. When spasticity is detected the ergometer pauses and passively stretches the muscle until the movement is free and rotation then progresses.  Sometimes when spasticity is sufficient to slow the speed of cycling to less than 20 rpm stimulation automatically ceases. As cycling speed builds again and exceeds 20rpm stimulation is added again.