International Journal of Physiotherapy and Research

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Type of Article : Original Research

Year: 2015 | Volume 3 | Issue 4 | Page No. 1163-1170

Date of Publication: 11-08-2015

DOI: 10.16965/ijpr.2015.161


Patitapaban Mohanty *1, Nishitha Meshram 2, Monalisa Pattnaik 3.  

*1 Associate professor, Department of Physiotherapy, SVNIRTAR, Olatpur, Cuttack Dt., Odisha. India.
2 Post Graduate, Department of Physiotherapy, SVNIRTAR, Olatpur, Cuttack Dt., Odisha. India.
3 Assistant Professor, Department of Physiotherapy, SVNIRTAR, Olatpur, Cuttack Dt., Odisha. India.

Corresponding author: Dr. Patitapaban Mohanty, Associate professor in Physiotherapy, SVNIRTAR, Olatpur, P.O.bairoi, Cuttack Dt., Odisha-754010, India. Mobile no.: +91 9437487139


Background: The impairments in cerebral palsy can limit a child’s ability to play and exercise at intensities necessary to develop cardio respiratory fitness.
Objective: To compare the effects of dynamic cycling, static cycling and conventional exercises in cardiovascular endurance, balance and walking ability in cerebral palsy children.
Materials and Method: A total of 30 subjects were recruited in an experimental pre-post-test study design. Subjects were randomly assigned to 3 different treatment groups. The following outcome measures were measured: resting Heart Rate, 3 Minute Walk Test, GMFM-66, and Pediatric Balance Scale. All the three groups received conventional exercises. The experimental group 1 in addition received dynamic cycling protocol and experimental group 2 received static cycling protocol. The outcome was again evaluated at 6 weeks.
Results: All the 3 groups showed significant pre to post improvement for the entire outcomes measured but GMFM-66. Results of the studied showed more significant improvement in both the cycling groups compared to the control group; Dynamic cycling group showing better response than static cycling group. Though all the groups showed improvement in GMFM-66, the dynamic cycling group showed better improvement followed by control group.
Conclusion: Dynamic cycling incorporated with conventional exercises improves the cardiovascular endurance, balance and functional abilities than conventional exercises only.
KEY WORDS: Cerebral Palsy, Dynamic Cycling, Static Cycling, Balance, Exercise, Walking, Endurance, Ability. 


  1. Gage JR. Gait Analysis in Cerebral Palsy, Mac Keith Press, NY. 1991.
  2. Sanger TD, Chen D, Delgado MR, et al. Definition and classification of negative motor signs in childhood. Pediatrics.2006;118:2159–2167.
  3. Dhalback G O, R Norlin. The effect of corrective surgery on energy expenditure during ambulation in children with cerebral palsy, Europian journal of applied physiology 1985;54:67-70.
  4. Unnithan VB, Dowling JJ, Frost G, Bar-OrO. Role of co-contraction in the O2 cost of walking in children with cerebral palsy. Med Sci Sports Exerc. 1996;28:1498–1504.
  5. Damiano et al. comparison of elliptical training, stationary cycling, treadmill walking and overground walking. Gait posture, 2011 june;34(2):260-264.
  6. Hansen, Ernst Albin, and S. M. I. Human Performance. On voluntary rhythmic leg movement behaviour and control during pedalling. Experimental Brain Research 2008;186:365-373.
  7. Morgan D, Keefer DJ, Tseh W, et al. Walking energy use in children with spastic hemiplegia. PediatrExerc Sci. 2005;17:91–92.
  8. Damiano DL, Vaughan CL, Abel MF. Muscle response to heavy resistance exercise in children with spastic cerebral palsy. Dev Med Child Neurol. 1995;37:731–739.
  9. EunSook Park, Chang-il P., Sung-Rac C., Jcong-Whan L. and EunJoo Kim. Assessment of autonomic nervous system with analysis of heart rate variability in children with spastic cerebral palsy. Yonsei Medical J. 2001;43(1):65-72.
  10. Carter, James B., Eric W. Banister, and Andrew P. Blaber. Effect of endurance exercise on autonomic control of heart rate. Sports medicine 2003;33(1):33-46.
  11. Raasch C, Zajac F. Locomotor strategy for pedaling: muscle groups and biomechnical functions. J Neurophysiol 1999;81:515-525.
  12. Ting LH, Kautz SA, Brown DA, Zajac FE. Phase reversal of biomechanical functions and muscle activity in backward pedaling. J Neurophysiol.1999;81:544–551
  13. Coast J., Welch H. Linear increase in optimal pedal rate with increased power output in cycle ergometry. Eur. J. Appl. Physiol. 1985;53:339–342.
  14. Winter D. Biomechanical motor patterns in normal walking. J. Mot. Behav. 1983;15:302–330.
  15. Brooke, J., Mcilroy, W., and Collins, D. Movement features and H-reflex modulation. Pedalling versus matched controls. Brain Res.1992;582:78–84.
  16. Brown, D. A. and Kukulka, C. G. Human flexor reflex modulation during cycling. J. Neurophysiol. 1993;69:1212-1224.
  17. Yang, J. and Stein, R. Phase-dependent reflex reversal in human leg muscles during walking. J. Neurophysiol. 1990;63:1109–1117.
  18. Raasch, C. C., Zajac, F. E., Ma, B., and Levine, W. S. Muscle coordination of maximum-speed pedaling. J. Biomech. 1997;30:595–602.
  19. Bradley, N. and Smith, J. Neuromuscular patterns of stereotypic hindlimb behaviors in the first two postnatal months. I. Stepping in normal kittens. Dev. Brain Res.1988;38:37–52.
  20. McCollum G. Reciprocal inhibition, synergies, and movements. J. Theor. Biol. 1993;165:291–311.
  21. Jacobs, R. and Macpherson, J. M. Two functional muscle groupings during postural equilibrium tasks in standing cats. J. Neurophysiol. 1996;76:2402–2411.
  22. Grillner, S. Locomotion in vertebrates: central mechanisms and reflex interaction. Physiol. Rev. 1975;55:247–304.
  23. Grillner, S. Control of locomotion in bipeds, tetrapods, and fish. In: Handbook of Physiology.The Nervous System. Motor Control.Bethesda, MD: Am. Physiol. Soc., 1981;1(2):1179–1236.
  24. Shik, M. L. and Orlovsky, G. N. Neurophysiology of locomotor automatism. Physiol. Rev. 1976;56:465–501.
  25. Marjorie Hines Woollacott and Anne Shumway-Cook. Postural Dysfunction During Standing and Walking in Children with Cerebral Palsy: What Are the Underlying Problems and What New Therapies Might Improve Balance? Neural Plasticity 2005;12(2-3):211-219.
  26. Shumway-Cook A, Hutchinson S, Kartin D, Price R, Woollacott M. Effect of balance training on recovery of stability in children with cerebral palsy. Dev Med Child Neurol 2003;45:591-602.
  27. Sandy  A Ross. Relationships Between Spasticity, Strength, Gait, and the GMFM-66 in Persons With Spastic Diplegia Cerebral Palsy. Archieves of physical ,med. And rehab sep 2007;88(9):1114-1120.
  28. Scholtes, Vanessa A., Annet J. Dallmeijer, Eugene A. Rameckers, Olaf Verschuren, Els Tempelaars, Maartje Hensen, and Jules G. Becher.  Lower limb strength training in children with cerebral palsy–a randomized controlled trial protocol for functional strength training based on progressive resistance exercise principles. BMC pediatrics 2008;8(1):41.
  29. Williams H, Pountney T. Effects of a static bicycling programme on the functional ability of young people with cerebral palsy who are non-ambulant. Dev Med Child Neurol 2007;49:522–527.


Patitapaban Mohanty, Nishitha Meshram, Monalisa Pattnaik. COMPARISION OF DYNAMIC CYCLING VS STATIC CYCLING ON ENDURANCE, BALANCE, AND WALKING ABILITY OF CHILDREN WITH CEREBRAL PALSY. Int J Physiother Res 2015;3(4):1163-1170. DOI: 10.16965/ijpr.2015.161




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