Bicycle ergometer and electromyographic feedback for treatment of muscle imbalance in patients with spastic hemiparesis. Suggestion from the field

Bicycle ergometer and EMG feedback can be used together to assist in correcting muscle imbalance around a joint and to help train patients with hemiparesis to perform reciprocal lower extremity exercise with a degree of symmetry and speed that one might have thought impossible from observing their gait. A 46-year-old man had suffered a left cerebrovascular accident two years earlier and had received a course of conventional physical therapy during the early months of recovery. At the time of reevaluation, he was ambulating independently wit a cane. Changes observed in gait after the ergometer training program included absence of previously observed hip circumduction, a decrease in trunk flexion during swing-through, and increased hip extension toward the end of stance. When lying prone, the patient was able to flex the knee through the full passive ROM. The stretching program had decreased quadriceps femoris muscle tightness in the Thomas test position.