A novel biofeedback cycling training to improve gait symmetry in stroke patients: a case series study

The restoration of walking ability is crucial for maximizing independent mobility among patients with stroke. Leg cycling is becoming an established intervention to supplement ambulation training for stroke patients with problems of unbalance and weakness. The aim of the study was to explore the feasibility of a biofeedback pedaling treatment and its effects on cycling and walking ability in chronic stroke patients. Three patients were included in the study. The training consisted of a 2-week treatment of 6 sessions, during which a visual biofeedback helped the participants in maintaining a symmetrical pedaling. Participants were assessed before, after training and at follow-up, by means of a pedaling test and gait analysis. Outcome measurements were the unbalance during pedaling, the temporal, spatial and symmetry parameters during walking. An intra-subject statistical analysis (ANOVA, p<;0.05) showed that all patients significantly decreased pedaling unbalance after treatment and maintained the improvements at follow-up. The training induced some gait pattern modifications in two patients: one significantly improved mean velocity and gait symmetry, while the other one reduced the compensation strategy of the healthy leg. The results demonstrated the feasibility of the treatment. If further trials on a larger and controlled scale confirmed the same results, this treatment, thanks to its safety and low price, could have a significant impact as a home-rehabilitation treatment.