SCIENCE AND RESEARCH
Regular physical exercise is widely accepted as a key factor in improving physical and mental health. Access or the ability to exercise regularly, however, is not the same for all individuals. RORO has sought to address this imbalance by providing regular, one-to-one aerobic exercise through assisted cycling. In doing so, RORO has helped numerous people across Bristol suffering from a wide-range of disabilities or mobility-impacting factors. It has allowed these people to spend time outdoors, to increase their independence and improve their physical health. The benefits of regular aerobic exercise are not only backed up by anecdotal evidence from RORO’s clients, but are also widely supported by a broad base of scientific, medical and developmental health research. This document will outline the academic and scientific evidence of the many benefits RORO can provide for individuals with/in:
● Autism Spectral Disorders (ASD) ● Mental Health Disorders
● Acquired Brain Injuries ● Parkinson’s Disease
● Cerebral Palsy ● Stroke Recovery
Autism Spectral Disorders (ASD)
● Where individuals with ASD have a broad set of symptoms, such as impaired social skills, communication ability and motor skills, standardised treatments that aim to alleviate all these symptoms simultaneously have proven to be very effective. Regular aerobic exercise is one such standardised treatment.
● A collation of studies on the benefits of regular exercise on children and adolescents with ASD found that individual rather than group exercise was most effective at reducing stereotypic behaviours of ASD. In particular, regular non-group exercise was found to dramatically improve motor skills and, perhaps counter-intuitively, social skills (Sola & Meulenbroek, 2012).
● Factors specific to ASD, as well as environmental factors created through ASD, have led to a high comorbidity with obesity in both children and adolescents. Regular exercise not only reduces the stereotypic behaviours of ASD, but also provides a rare and valuable opportunity to alleviate the risk of obesity through energy expenditure (Srinivisan et al, 2014).
Acquired Brain Injuries
● Disability following brain injury occurs either as a result of direct neurological damage, or through secondary and avoidable factors such as physical inactivity or immobility. In situations where ABI patients are not entirely disabled by the neurological damage of their injury, regular aerobic exercise such as that provided by RORO can reduce the risk of further disability or long-term damage (Bateman et al, 2001).
● As well as physical benefits of regular aerobic exercise during ABI rehabilitation, Graely et al (1999)’s study on the effects of a 4-week of aerobic exercise intervention amongst ABI victims revealed improvements in verbal and visual learning tasks, reaction and movement times and concentration, noticeable even following just one bout of exercise.
Cerebral Palsy
● Over a 12-week period of regular one hour sessions, the use of a semi-recumbent bicycle with a wide seat, foot straps and trunk support like that used by RORO, resulted in significant improvements in both the GMFM-66 and in a 600 yard walk/run test amongst a diverse group of children with cerebral palsy (Fowler et al, 2010).
● A further study by Verschuren et al. (2007) revealed that completing two 45-minute sessions of circuit exercise a week markedly improved the aerobic and anaerobic capacity of cerebral palsy patients, as well as also improving their agility and the muscle strength of their lower extremities. Moreover, improvements were also noted in the patients’ perception of their own athletic competency
Mental Health Disorders
● The correlation between exercise intervention and the attenuation of the symptoms of depression or anxiety disorders is well-described anecdotally, however an increasing body of academic research has provided a more substantive basis for these claims.
● Physical activity has been repeatedly linked with improved mental wellbeing, cognitive functioning and life satisfaction, where inactivity has been shown to correlate with the development of mental health disorders. In particular, the effectiveness of regular exercise in alleviation mental health disorders such as mild or moderate depression compares favourably to pharmacologic measures as a first-line response (Carek et al, 2011).
● Aerobic exercise, involving prolonged and sustained physical exertion of large muscle group areas, such as that provided through RORO, has been shown to be the most effective form of exercise for mental health disorder alleviation, with a wide-evidence base showing clear mood improvement following (non-competitive) aerobic exercise (Salmon, 2001).
Parkinson’s Disease
● Where Parkinson’s Disease’s physical symptoms such as a decline in motor skills can be treated through pharmacological means, these measures have little to no effect on the decline of cognitive functioning through PD. Other measures, therefore, are required to work in tandem with medical interventions to limit the cognitive symptoms. One intervention that has had proven benefits in this area is passive-cycling, as provided by RORO. A study by Ridgel et al, 2011, showed significant improvements in cognitive functioning test results following periods of passive leg cycling in Parkinson’s patients compared to tests completed before exercise.
● Assisted or passive cycling can also alleviate the physical symptoms of Parkinson’s Disease, as evidenced by a further study by Ridgel et al (2010). This study showed that following a single 40-minute session of assisted cycling, there was a notable reduction in the instance of both tremors and bradykinesia in Parkinson’s Disease patients, to a level almost akin to the on-medication state.
Stroke Recovery
● Physical activity or exercise following a stroke has been posited to prevent further disability and stroke recurrence, however mobility-reduction following a stroke can limit the ability to practise exercise (Damush, 2012). Assisted exercise then, such as that provided by RORO, is a key option in overcoming these access barriers.
● As well as reducing the risk of stroke recurrence, aerobic exercise can also form a key part of stroke rehabilitation through improvements in physical strength and condition. Following a 16-week period of exclusively aerobic exercise in stroke survivors aged between 30-82 (in the form of three 20-minute weekly sessions on an assisted upper and lower-body ergometer), Carr and Jones (2003), noted an improved knee flexion and shoulder extension in participants, as well positive metabolic changes and improvements in functional strength.
References
Sola, M., & Meulenbroek, R. (2012). Effects of physical exercise on Autism Spectrum Disorders: A meta-analysis. Research in Autism Spectral Disorders 6(1): 46-57. Srinivisan, S., Pescatello, L., & Bhat, A. (2014). Current Perspectives on Physical Activity and Exercise Recommendations for Children and Adolescents With Autism Spectrum Disorders. Physical Therapy 94(6): 875-889.
Bateman, A., Culpan, F., Pickering, A., Powell, J., Scott, O., & Greenwood, R. (2001). The effect of aerobic training on rehabilitation outcomes after recent severe brain injury: a randomized controlled evaluation. Archives of Physical Medicine and Rehabilitation 82(2): 174-182. Graely, M., Johnson, D., & Rushton, S. (1999). Improving cognitive function after brain injury: the use of exercise and virtual reality. Archives of Physical Medicine and Rehabilitation 80(6): 661-667.
Fowler et al., (2010). Pediatric Endurance and Limb Strengthening (PEDALS) for children with Cerebral Palsy using stationary cycling: a randomised controlled trial. Physical Therapy 90(3): 367-381. Vershuren, O., Ketelaar, M., & Gorter, J. (2007). Exercise training programme for children and adults with cerebral palsy: a randomised controlled trial. Archives of Pediatrics and Adolescent Medicine 161(11): 1075-1081.
Carek, P., Laibstain, S., & Carek, S. (2011). Exercise for the treatment of depression and anxiety. International Journal of Psychiatry in Medicine 41(1): 15-28. Salmon, P. (2001). Effects of physical exercise on anxiety, depression and sensitivity to stress: a unifying theory.
Ridgel et al., (2011). Changes in executive function after acute bouts of passive cycling in Parkinson’s Disease. Journal of Aging and Physical Activity 19(2): 87-98. Ridgel, A., Peacock, C., Fickes, E. & Kim, C. (2010). Active-assisted cycling improves tremors and bradykinesia in Parkinson’s Disease. Archives of Physical Medicine and Rehabilitation.
Damush, T., Plue, L., Bakas, T., Schmid, A., & Williams, A. (2012). Barriers and facilitators to exercise among stroke victims. Rehabilitation Nursing 32(6): 253-262. Carr, M., & Jones, J. (2003). Physiological effects of exercise on stroke survivors. Topics on Stroke Rehabilitation 9(4): 57-64.