Spinal Cord Injuries and Traumatic Brain Injuries 

Cardiovascular exercise can have a positive impact on people with spinal cord injuries (SCI) and traumatic brain injuries (TBI) in several ways including improvements in cardiovascular fitness, aerobic capacity and exercise tolerance as well as neural and muscular function.  NuStep recumbent cross trainers have been used in multiple studies as an exercise modality for individuals who experienced spinal cord and traumatic brain injuries as well as those with neurological impairments. 

Studies and Summaries: 

Neural coupling between upper and lower limbs during recumbent stepping

J Appl Physiol | 2004

Research Summary

In this study, the authors noted that the self-assisted stepping mechanism of the NuStep recumbent cross trainer may be able to “capitalize on neural coupling between the upper and lower limbs during rhythmic locomotor like tasks.”  Study also indicates neurologically impaired people using their upper limbs while recumbent stepping may increase neuromuscular activation. 

Authors

Huang HJ, Ferris DP.

 

Clinical Practice Guideline to Improve Locomotor Function Following Chronic Stroke, Incomplete Spinal Cord Injury, and Brain Injury

Journal of Neurologic Physical Therapy | 2020

Research Summary

Clinical evidence supports cycle or recumbent stepping interventions for individuals with spinal cord injury (SCI) and traumatic brain injury (TBI): 

Action Statement 4: CYCLING INTERVENTIONS FOLLOWING ACUTE-ONSET CENTRAL NERVOUS SYSTEM (CNS) INJURY. Based on the preponderance of evidence for individuals poststroke and no evidence for individuals with iSCI and TBI, clinicians may consider use of cycling or recumbent stepping interventions at higher aerobic intensities instead of alternative interventions to improve walking speed and distance in individuals greater than 6 months following acute-onset CNS injury as compared with alternative interventions (evidence quality: I-II; recommendation strength: weak for individuals with stroke). 

 A link to the comprehensive guidelines is available here  Journal of Neurologic Physical Therapy (lww.com) 

Authors

Hornby, T. George PT, PhD; Reisman, Darcy S. PT, PhD; Ward, Irene G. PT, DPT, NCS; Scheets, Patricia L. PT, DPT, NCS; Miller, Allison PT, DPT, NCS; Haddad, David PT, DPT; Fox, Emily J. PT, PhD, NCS; Collaborators; Fritz, Nora E. PT, PhD, NCS; Collaborators; Hawkins, Kelly PT, PhD, NCS; Collaborators; Henderson, Christopher E. PT, PhD, NCS; Collaborators; Hendron, Kathryn L. PT, PhD, NCS; Collaborators; Holleran, Carey L. PT, DHS, NCS; Collaborators; Lynskey, James E. PT, PhD; Collaborators; Walter, Amber PT, DPT, NCS; Collaborators.

Effects of aerobic exercise training on fitness and walking-related outcomes in ambulatory individuals with chronic incomplete spinal cord injury

Spinal Cord | 2016

Research Summary

The individuals who participated in the study were ambulatory adults with chronic motor-incomplete spinal corde injury (SCI).  The exercise protocol on the T5XR did meet the Aerobic Exercise Training requirements for individuals who had experienced an SCI.  

The fitness and walking related outcomes are noted in Table 3 in the article. The authors also noted the following in the discussion: 

On the basis of the findings, we recommend AET on a recumbent stepper as a feasible alternative or adjuvant to current interventions aimed at improving walking outcomes in ambulatory individuals with incomplete SCI. Compared with other modalities such as locomotor training and robotic-assisted gait training, AET on a recumbent stepper requires fewer personnel, uses less expensive equipment and may be more time efficient, thus increasing the benefits of this option.”  

Authors

DiPiro, N., Embry, A., Fritz, S. et al.

A 16-week randomized controlled trial evaluating the physical activity guidelines for adults with spinal cord injury

Spinal Cord | 2015

Research Summary

The objective of this study was to evaluate the effectiveness of the physical activity guidelines (PAG) for adults with spinal cord injury (SCI) to improve aspects of physical fitness. The NuStep T5XR was one of the pieces of aerobic exercise equipment used as part of a comprehensive program which included aerobic and resistance exercise.    

The authors concluded that the PAG for adults with SCI are sufficient to improve aspects of aerobic and muscular fitness and should be promoted as a means to improve physical capacity. 

Authors

Pelletier, C., Totosy de Zepetnek, J., MacDonald, M. et al.