Comparison of muscular activity on ergometric bicycle and elliptical trainer in subjects with incomplete spinal cord injury

Abstract Introduction Spinal cord injury generates muscle weakness, impairing orthostatism and gait. The elliptical trainer (ET) and the ergometric bicycle (EB) are rehabilitation options for this subject. Understanding the pattern of muscle activation generated by these methods is important to answer questions arising from clinical practice. Objective To verify muscle activation with ET and EB with and without electromyographic biofeedback in subjects with incomplete spinal cord injury (ISCI). Methods Cross-sectional crossover study, enrolled in Clinical Trials (NCT05118971). Subjects with spinal cord injury (incomplete spinal cord injury group - ISCIG) and without spinal cord injury (reference group - RG) were randomized into four groups: elliptical group (EG), elliptical + biofeedback group (EBG), bicycle group (BG) and bicycle + biofeedback group (BBG). Subjects were assessed for functionality by the Functional Independence Measure, injury classification by the ASIA Scale, muscle tone by the modified Ashworth scale, and muscle activity by electromyography. Results There was greater activation of the tibialis anterior on cycling compared to other modalities in ISCIG. Biofeedback offered no difference in any of the groups. In RG the vastus medialis was the most activated muscle in all modalities, with more expressive activation in the ET. In this same group, the tibialis anterior was more activated on the EB. Conclusion This study showed that both ET and EB are safe and effective in recruiting the muscles investigated, encouraging its use by rehabilitation professionals when the objective is to strength muscles involved in gait. Resumo Introducão A lesão medular gera fraqueza muscular, preju-dicando o ortostatismo e a marcha. O aparelho elíptico (EL) e a bicicleta ergométrica (BE) são opções de reabilitação para estes sujeitos. Compreender o padrão de ativação muscular gerado por esses métodos é importante para esclarecer dúvi-das advindas da prática clínica. Objetivo Verificar a ativação muscular com EL e BE com e sem biofeedback eletromiográfico em indivíduos com lesão medular incompleta (LMI). Métodos Estudo transversal do tipo crossover, inscrito no Clinical Trials (NCT05118971). Sujeitos com lesão medular (grupo lesão medular incompleta - GLMI) e sem lesão medular (grupo refe-rência - GR) foram randomizados em quatro grupos: elíptico (GE), elíptico + biofeedback (GEB), bicicleta (GB) e bicicleta + biofeedback (GBB). Os indivíduos foram avaliados qua