Feasibility of a new bicycle ergometer with adjustable pedaling configuration for personalized lower limb rehabilitation

Muscle atrophy due to prolonged immobilization leads to severe dysfunction and progression of disease and injury. This highlights the necessity for early rehabilitation, even during the non-ambulatory stages. As manifestations vary among individuals, target-specific rehabilitation is crucial for achieving optimal outcomes. Conventional bicycle ergometers, despite their wide usage in rehabilitation and sports training, fail to adequately recruit the muscles that predominantly operate in the coronal or axial plane. This is thought to be due to the restriction of pedaling trajectory in the sagittal plane. This study introduces a new bicycle ergometer capable of tilting the pedaling plane and adjusting the pedal orientation, in order to alter muscle recruitment patterns and limb alignments. A biomechanical analysis of eight healthy volunteers suggests that our device can elicit dynamic valgus/varus alignment and alter the axial rotations of the lower extremities. An electromyography analysis revealed a significant increase in the activation of specific muscle groups, particularly the abductors and adductors, suggesting promising results for targeted muscle recruitment. We expect this ergometer to provide a new method for target-specific rehabilitation and the treatment of bedridden patients or those with weak muscles.