Evidence of the health benefits by active-passive cycling training

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Written by Marissa Hoen | November 17 2020

The extent of your mobility is impacted by so many factors, and may look today different than it did a year ago. Maybe you’ve seen gains in your range of motion from all your hard work, or maybe this year has limited your options and movement hasn’t been a huge priority (like so many of us this year). Today I wanted to share the benefits of passive mobility, specifically active-passive trainers (also known as APT or MotoMed) as it is one of the most popular devices at MOVE that can help mobilize a wide range of individuals.

Are my muscles being used during passive cycling?

  • If you are truly cycling passively (no brain stimulated muscle contractions) the machine should be doing the work of moving your legs in a cyclical motion. As your legs begin to move, your large muscle groups (quads, hamstrings, calves) are being stretched and then shortened. This may stimulate stretch receptors that result in muscle contraction, or move the muscles around the veins in your legs providing a muscle pump- directing blood and swelling up and out of the legs. 


So, what are these benefits?

  • “Three studies (including two RCTs) reported statistically significant benefits of multiple sessions of passive cycling on leg blood flow velocity, spasticity, reflex excitability and joint range of motion, and markers of muscle hypertrophy.”1
     

  • This means that consistent passive cycling can:1

-increase in blood flow speed without an increasing heart rate

-increase blood flow to legs

-decrease spasticity in those with SCI

- increase range of motion 

-decrease in muscle and tendon stiffness

-potentially decrease muscle atrophy and stimulate muscle building

-improve cognitive function in individuals with Parkinson’s Disease2

  • There is not enough evidence in APT use with people with SCI to determine the cardiovascular effects of just one session of passive cycling, but just one session has been shown to have neurological effects in decreasing spasticity. However, consistent cycling has greater and more lasting effects on the cardiovascular, muscular, and nervous systems.1


Are there greater improvements with faster cycling speeds?

Maybe, maybe not! What we do know:

  • Blood pressure increases with increasing cadence in all subjects who underwent a graded passive cycling exercise (increasing speed of the machine incrementally)3.

  • Each individual responds differently to the passive cycle in terms of heart rate, blood flow velocities, and other cardiovascular variables. 

  • Some individuals showed decreased cardiac function in response to greater passive cadence, however more research is needed before conclusions are drawn. 

  • As of now, no direct link has been found between level of MS related spasticity improvement and cadence of passive cycle.4

Take Away-

  • Cardiovascular, muscular, and nervous systems adapt to passive cycling training1 

  • Passive and active cycling has been shown as a safe and effective method of movement for people with SCI, PD, and MS



REFERENCES

  1. Phadke, C. P., Vierira, L., Mathur, S., Cipriano, G., Jr, Ismail, F., & Boulias, C. (2019). Impact of Passive Leg Cycling in Persons With Spinal Cord Injury: A Systematic Review. Topics in spinal cord injury rehabilitation, 25(1), 83–96. https://doi.org/10.1310/sci18-00020

  2. Kim, C., Muller, M. D., Fickes, E. J., Alberts, J. L., & Ridgel, A. L. (2010). Acute bouts of passive leg cycling can improve cognitive function in parkinson's patients: 2745. Medicine and Science in Sports and Exercise, 42(5), 735. doi:10.1249/01.MSS.0000386133.61205.04

  3. Chen, J., Martin, C., McIntyre, C. W., Ball, I. M., Duffin, J., & Slessarev, M. (2019). Impact of graded passive cycling on hemodynamics, brain, and heart perfusion in healthy adults. Frontiers in Medicine, 6, 186-186. doi:10.3389/fmed.2019.00186

  4. Barclay, A., Paul, L., MacFarlane, N., & McFadyen, A. K. (2019). The effect of cycling using
    active-passive trainers on spasticity, cardiovascular fitness, function and quality of life in people with moderate to severe multiple sclerosis (MS); a feasibility study. Multiple Sclerosis and Related Disorders, 34, 128-134. doi:10.1016/j.msard.2019.06.019

  5. Image credit: https://www.dreamstime.com/illustration/recumbent-bike.html