The effects of hybrid cycling on fitness and physical activity in people with long-term spinal cord injury: a randomized controlled trial

Janssen TWJ. Effects of 16-week hybrid cycle versus handcycle exercise on fitness and physical activity in inactive people with long-term spinal cord injury. Spinal Cord. Abstract Study Design: Open randomized controlled trial. Objective: To investigate the effects of a 16-week hybrid cycle versus handcycle exercise program on fitness, pulmonary function and physical activity in inactive people with long-term spinal cord injury (SCI). Setting: Two rehabilitation centers with a specialized SCI unit. Methods: Twenty individuals with SCI (time since injury ≥ 8 years) were randomly assigned to either the hybrid cycle (voluntary arm exercise combined with functional electrical stimulation (FES)-induced leg exercise) or handcycle group. During 16 weeks, both groups trained twice a week for 18–30 minutes at 65–75% heart rate reserve. Outcome measures obtained pre, mid and post the program were fitness (peak power output (POpeak), peak oxygen consumption (VO 2peak), resting heart rate (HR rest) and wheelchair skill performance time score (PTS)), pulmonary function, and physical activity (distance travelled in wheelchair (WC dist) and Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) score). Differences between pre, mid and post outcome measures were examined using a two-factor (time × group) mixed-measures ANOVA. Results: Overall, ~40% and ~65% of the participants showed (non-significant) improvements in PO peak (p = 0.11) and VO 2peak (p = 0.14) following the 16-week training program, respectively. Furthermore, an overall reduction in HR rest (–5 ± 2 bpm; p = 0.03) and an overall increase in PASIPD score (6.5 ± 2.1; p = 0.002) were found after 16 weeks of training. No significant overall training effects were found for PTS, pulmonary function and WC dist. For all the obtained outcome measures, there were no significant differences over time between the two training groups. Conclusion: In the current study, hybrid cycling and handcycling showed similar effects on fitness, pulmonary function and physical activity, indicating that there were no additional benefits of FES-induced leg exercise above handcycle exercise.