Assisted cycling in non-ambulant adults with cerebral palsy: exploratory effects and feasibility in residential care

Adults with cerebral palsy (Gross Motor Function Classification System, GMFCS, levels III-V) have severely impaired motor function, causing fatigue, pain, constipation, and sleep disturbance, reducing life quality. Whether standard exercise is feasible or beneficial in this population is unknown, as spasticity, low muscle mass, and cognitive challenges may limit participation. Unable to engage in conventional exercise, they require tailored modalities. This study investigated whether assisted cycling is feasible and could improve key symptoms.

14 adults with cerebral palsy (GMFCS III-V) completed a 10-week control period and 10 weeks of supervised, assisted cycling (3 x 20 min/week). Assessments at baseline, post-control, and post-exercise included key symptoms, feasibility, Gross Motor Function Measure-88, and a timed 1-km cycle test (time, power output, cadence).

Median attendance was 24/30 sessions. Heart rate increased during exercise (median 25.5 bpm). No significant group-level changes were observed, but individual improvements in pain, constipation, and power output were observed in some. Two participants experienced moderate adverse events affecting daily living.

Assisted cycling is feasible and generally well tolerated in non-ambulant adults with cerebral palsy. While no group-level effects were detected, exploratory individual improvements in symptoms and cycling performance were observed in some, supporting further research on tailored exercise.