This study aimed to investigate the effectiveness of biofeedback cycling training on lower limb functional recovery, walking endurance, and walking speed for patients with chronic stroke. Thirty-one patients with stroke (stroke onset > 3 months) were randomly assigned into two groups using a crossover design. One group (n = 16; mean: 53.6 +/- 10.3 years) underwent conventional rehabilitation and cycling training (30 minutes/time, 5 times per week for 4 weeks), followed by only conventional rehabilitation for another 4 weeks. The other group (n = 15; mean 54.5 +/- 8.0 years) underwent the same training in reverse order. The bike used in this biofeedback cycling training was the MOTOmed viva2 Movement Trainer. Outcome measures included the lower extremity subscale of Fugl-Meyer assessment (LE-FMA), the 6-minute walk test (6MWT), the 10-meter walk test (10MWT), and the modified Ashworth scale (MAS). All participants were assessed at the beginning of the study, at the end of the 4th week, and at the end of the 8th week. Thirty participants completed the study, including the cycling training interventions and all assessments. The results showed that improvements in the period with cycling training were significantly better than the noncycling period in the LE-FMA (p < 0.05), 6MWT (p < 0.001), 10MWT (p < 0.001), and MAS (p < 0.001) scores. No significant carryover effects were observed. The improvements on outcome measures were significantly different between the cycling period and the noncycling period after adjusting for potential confounding factors in the multivariate analysis of variance (p < 0.001). The study result indicates that the additional 4-week biofeedback cycling training could lead to improved LE functional recovery, walking endurance, and speed for patients with chronic stroke.

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