Research Article| Volume 29, ISSUE 9, 105035, September 2020

Pedaling improves gait ability of hemiparetic patients with stiff-knee gait: fall prevention during gait


      • After pedaling, rectus femoris activity decreased at the swing phase during gait.
      • The flexion angles and angular velocity of the knee increased during the swing phase.
      • Pedaling increases foot clearance in stiff-knee gait and may reduce the fall risk.


      Background and Purpose

      Stiff-knee gait, which is a gait abnormality observed after stroke, is characterized by decreased knee flexion angles during the swing phase, and it contributes to a decline in gait ability. This study aimed to identify the immediate effects of pedaling exercises on stiff-knee gait from a kinesiophysiological perspective.


      Twenty-one patients with chronic post-stroke hemiparesis and stiff-knee gait were randomly assigned to a pedaling group and a walking group. An ergometer was set at a load of 5 Nm and rotation speed of 40 rpm, and gait was performed at a comfortable speed; both the groups performed the intervention for 10 min. Kinematic and electromyographical data while walking on flat surfaces were immediately measured before and after the intervention.


      In the pedaling group, activity of the rectus femoris significantly decreased from the pre-swing phase to the early swing phase during gait after the intervention. Flexion angles and flexion angular velocities of the knee and hip joints significantly increased during the same period. The pedaling group showed increased step length on the paralyzed side and gait velocity.


      Pedaling increases knee flexion during the swing phase in hemiparetic patients with stiff-knee gait and improves gait ability.


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