Can Recumbent Exercise Improve Gait and Arterial Stiffness Outcomes? - a Longitudinal Case Study

Document Type

Article

Publication Date

2022

Publication Title

International Journal of Exercise Science-Conference Proceedings

Abstract

Unilateral deficiencies in leg function may compromise the utility of upright and bipedal exercise, but recumbent exercise modes in such individuals provide a plausible alternative for fitness improvements. The purpose of this case study was to examine how longitudinal recumbent exercise may affect gait and arterial stiffness outcomes. METHODS: A 69-year-old female with history of left femur fracture participated in a supervised 6-week (2x per week) exercise program on the recumbent cross trainer (ReCT) at level 1 resistance. Gait outcomes were obtained prior to and one month into the intervention with the GAITRite system. Preceding each exercise bout, the participant completed (n = 3) sagittal plane dynamic mobility drills of the hip, knee and ankle. The initial exercise pace was guided by the participant’s rating of perceived exertion (RPE). Targeted and externally focused verbal instructions were utilized to optimize the transfer to gait. Resting blood pressure (brachial and aortic) and carotid-femoral pulse wave velocity (cf-PWV) was evaluated prior to and 6 weeks into the intervention using pulse wave analysis and pulse wave velocity. Time was progressed 5-10% each week as tolerated. Intra-intervention pain was monitored with the short-form McGill Pain Questionnaire 2 (sf-MPQ2). RESULTS: After 6 weeks, 20 minutes of continuous exercise at an RPE of 12-14 was well-tolerated. The intervention increased gait velocity (FW: +13.1 cm/sec; BW: +23.6 cm/sec), increased bilateral step length (FW: +5.27cm(L), +5.76cm (R); BW: +8.03cm (L), +17.55cm (R) while double support percentage was reduced (FW: -3.15%(L), -3.95% (R); BW: -6.5%). The stance % of each FW gait cycle was also reduced (L: Pre: 68.2% vs. Post: 67.5%; R: Pre: 68.95% vs. Post: 66.7%). Reductions in brachial and aortic systolic (-12mmHg) and diastolic (-11mmHg) pressures were similar, and cf-PWV was reduced from 9.3 m/s to 7.4 m/s. sf-MPQ-2 outlined subjective improvements in perceived exhaustion, superficial tenderness, and fear of falling. CONCLUSION: These findings provide preliminary support for the longitudinal use of recumbent NCT exercise for gait retraining. Furthermore, these findings support the pursuit of larger scaled investigations for attenuating arterial stiffness in the elderly with compromised postural control.

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