Wheelchair bound patients with MD or CP live a sedentary life, and probably because of
this, many experience pain in lower back and glutes, obstipation, reduced quality of
life, reduced activity of daily living and social withdrawal. Exercise is likely to
reduce these symptoms. However, research in exercising patients confined to a wheelchair
lacks 3 things: 1) Most research is done in patients that are wheelchair bound due to
stroke, and these results are not necessarily transferable to patients with MD or CP.
Patients with stroke differ from patients with MD and CP since they can potentially gain
walking ability again, they have had walking ability up to the stroke, they are only
hemiparetic and thus have normal function in the rest of the body, their muscles are
atrophic but otherwise healthy and they have no contractures. 2) Most research in
exercise in patients with MD or CP focuses on preventing patients from being wheelchair
bound - only very little research is done in the most severely affected patients that are
wheelchair bound, although many of their symptoms can potentially be ameliorated by
exercise. 3) To date, research in exercise in wheelchair bound patients with MD or CP has
primarily consisted of arm cycling. It has been shown to reduce BMI and improve
cardiorespiratory status, endurance, muscle strength and activities of daily living, but
not without complications. The upper limbs consist of small muscle groups that are easily
fatigued and therefore proper cardiopulmonary fitness is difficult to obtain. The risk of
upper limb overuse injuries is high, reducing patients function and activities of daily
living. Presently, there is no feasible and acceptable way to exercise for this large
patient group.
The investigators have tested a cycle ergometer for the lower limbs that can be used
while the patients sit in their own wheelchair. It has a motor, since most patients are
not able to turn the pedals themselves, and a sensor that can measure how much patients
contribute to cycling. They have tested 3 wheelchair bound patients. After training, they
all experienced reduced pain in lower back and glutes, less obstipation and increased
energy. Surprisingly, the heart rate increased during exercise by up to 65 beats even in
patients that could not turn the pedals themselves, indicating cardiovascular fitness. To
test this form of exercise in a larger group of patients that are wheelchair bound due to
MD or CP will be of great interest.
The aim of this project is thus:
to test a cycle ergometer for lower limbs in patients who are wheelchair bound due
to MD or CP to find a feasible and acceptable way to exercise in order to increase
health and quality of life.
to investigate if patients unable to move their legs will have effect of the
training.