{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:37:13Z","timestamp":1781073433955,"version":"3.54.1"},"reference-count":57,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2019,9,1]],"date-time":"2019-09-01T00:00:00Z","timestamp":1567296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,9,1]],"date-time":"2019-09-01T00:00:00Z","timestamp":1567296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100011698","name":"Chartered Society of Physiotherapy Charitable Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011698","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","msard-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis and Related Disorders"],"published-print":{"date-parts":[[2019,9]]},"DOI":"10.1016\/j.msard.2019.06.019","type":"journal-article","created":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T02:45:00Z","timestamp":1560825900000},"page":"128-134","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":27,"special_numbering":"C","title":["The effect of cycling using active-passive trainers on spasticity, cardiovascular fitness, function and quality of life in people with moderate to severe Multiple Sclerosis (MS); a feasibility study."],"prefix":"10.1016","volume":"34","author":[{"given":"A.","family":"Barclay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"MacFarlane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.K.","family":"McFadyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"2","key":"10.1016\/j.msard.2019.06.019_bib0001","first-page":"103","article-title":"Use of surface EMG for evaluation of upper limb spasticity during botulinum toxin therapy in stroke patients","volume":"25","author":"Albani","year":"2010","journal-title":"Funct. Neurol."},{"key":"10.1016\/j.msard.2019.06.019_bib0002","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1136\/jnnp.74.5.646","article-title":"The relation between ashworth scale scores and the excitability of the alpha motor neurones in patients with post-stroke muscle spasticity","volume":"74","author":"Bakheit","year":"2003","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"10.1016\/j.msard.2019.06.019_bib0003","doi-asserted-by":"crossref","first-page":"2993","DOI":"10.1007\/s00415-013-7091-z","article-title":"Endurance training in MS: short-term immune responses and their relation to cardiorespiratory fitness, health-related quality of life, and fatigue","volume":"260","author":"Bansi","year":"2013","journal-title":"J. Neurol."},{"issue":"2","key":"10.1016\/j.msard.2019.06.019_bib0004","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.09.006","article-title":"The application of cycling and cycling combined with feedback in the rehabilitation of stroke patients: a review","volume":"24","author":"Barbosa","year":"2015","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"10.1016\/j.msard.2019.06.019_bib0005","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.apmr.2014.09.033","article-title":"Functional electrical stimulation \u2013 assisted active cycling \u2013 therapeutic effects in patients with hemiparesis from 7 days to 6 months after stroke: a randomized controlled pilot study","volume":"96","author":"Bauer","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"10.1016\/j.msard.2019.06.019_bib0006","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1016\/j.apmr.2014.02.017","article-title":"Improved physical fitness correlates with improved cognition in multiple sclerosis","volume":"95","author":"Beier","year":"2014","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"10.1016\/j.msard.2019.06.019_bib0007","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.apmr.2005.08.130","article-title":"Determination of the minimal clinically important difference in the FIM instrument in patients with stroke","volume":"87","author":"Beninato","year":"2006","journal-title":"Arch. Phys. Med. Rehabil."},{"issue":"1","key":"10.1016\/j.msard.2019.06.019_bib0008","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1093\/ptj\/82.1.25","article-title":"Reliability of measurements obtained with the modified ashworth scale in the lower extremities of people with stroke","volume":"82","author":"Blackburn","year":"2002","journal-title":"Phys. Ther."},{"key":"10.1016\/j.msard.2019.06.019_bib0009","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1177\/026921559400800203","article-title":"The inter-rater reliability and construct validity of the functional independence measure for Multiple Sclerosis subjects","volume":"8","author":"Brosseau","year":"1994","journal-title":"Clin. Rehabil."},{"issue":"6","key":"10.1016\/j.msard.2019.06.019_bib0010","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1097\/PHM.0b013e3181d3e71f","article-title":"Cycling progressive resistance training for people with Multiple Sclerosis","volume":"89","author":"Cakit","year":"2010","journal-title":"Am. J. Med. Rehabil."},{"issue":"12","key":"10.1016\/j.msard.2019.06.019_bib0011","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1016\/j.clinthera.2014.08.006","article-title":"Update on disease-modifying treatments for Multiple Sclerosis","volume":"36","author":"Carrithers","year":"2014","journal-title":"Clin. Ther."},{"key":"10.1016\/j.msard.2019.06.019_bib0012","doi-asserted-by":"crossref","DOI":"10.1185\/03007995.2011.639752","article-title":"Minimally important clinical difference of the times 25-Foot walk Test: results from a randomized controlled trial in patients with multiple sclerosis","author":"Coleman","year":"2012","journal-title":"Curr. Med. Res. Opin."},{"key":"10.1016\/j.msard.2019.06.019_bib0013","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/j.1469-8749.2002.tb00296.x","article-title":"What does the ashworth scale really measure and are instrumented measure more valid and precise","volume":"44","author":"Damiano","year":"2002","journal-title":"Dev. Med. Child Neurol."},{"key":"10.1016\/j.msard.2019.06.019_bib0014","first-page":"3","article-title":"Chronic disease and the link to physical activity","year":"2013","journal-title":"J. Sport Health Sci."},{"key":"10.1016\/j.msard.2019.06.019_bib0015","doi-asserted-by":"crossref","first-page":"234","DOI":"10.2340\/16501977-2204","article-title":"Further characterization and validation of the oxygen uptake efficiency slope for persons with Multiple Sclerosis","volume":"48","author":"Edwards","year":"2017","journal-title":"J. Rehabil. Med."},{"key":"10.1016\/j.msard.2019.06.019_bib0016","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.msard.2017.06.003","article-title":"The effect of exercises training in adults with Multiple Sclerosis with severe mobility disability: a systematic review and future research directions","volume":"16","author":"Edwards","year":"2017","journal-title":"Mult. Scler. Relat. Disord."},{"key":"10.1016\/j.msard.2019.06.019_bib0017","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1177\/135245859900500410","article-title":"Recent developments in the assessment of quality of life in Multiple Sclerosis","volume":"5","author":"Fischer","year":"1999","journal-title":"Mult. Scler."},{"key":"10.1016\/j.msard.2019.06.019_bib0018","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1136\/jnnp.2009.177071","article-title":"Stop using the ashworth scale for the assessment of spasticity","volume":"81","author":"Fleuren","year":"2010","journal-title":"J Neurol. Neurosurg. Psychiatry"},{"issue":"7","key":"10.1016\/j.msard.2019.06.019_bib0019","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1249\/MSS.0b013e318213fefb","article-title":"Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise","volume":"43","author":"Garber","year":"2011","journal-title":"Med. Sci. Sports Exerc."},{"issue":"3","key":"10.1016\/j.msard.2019.06.019_bib0020","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1177\/1756285615576663","article-title":"Exercise in the management of persons with multiple sclerosis","volume":"8","author":"Giesser","year":"2015","journal-title":"Ther. Adv. Neurol. Disord."},{"issue":"3","key":"10.1016\/j.msard.2019.06.019_bib0021","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1046\/j.1440-1681.2002.03623.x","article-title":"Adaptations of skeletal muscle to prolonged, intense endurance training","volume":"29","author":"Hawley","year":"2002","journal-title":"Clin. Exp. Pharmacol. Physiol."},{"key":"10.1016\/j.msard.2019.06.019_bib0022","doi-asserted-by":"crossref","first-page":"656","DOI":"10.2340\/16501977-1825","article-title":"Validity of oxygen uptake efficiency slope in patients with multiple sclerosis","volume":"46","author":"Heine","year":"2014","journal-title":"J. Rehabil. Med."},{"key":"10.1016\/j.msard.2019.06.019_bib0023","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1093\/brain\/awh675","article-title":"Getting the measure of spasticity in multiple sclerosis: the multiple sclerosis spasticity scale (MSSS-88)","volume":"129","author":"Hobart","year":"2006","journal-title":"Brain"},{"issue":"4","key":"10.1016\/j.msard.2019.06.019_bib0024","first-page":"831","article-title":"Adaptations of skeletal muscle to endurance exercise and their metabolic consequences","volume":"56","author":"Holloszy","year":"1984","journal-title":"J. Appl. Physiol. Respir. Environ. Exerc. Physiol."},{"key":"10.1016\/j.msard.2019.06.019_bib0025","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1159\/000360528","article-title":"Multiple sclerosis: current knowledge and future outlook","volume":"72","author":"Kamm","year":"2014","journal-title":"Eur. Neurol."},{"issue":"5","key":"10.1016\/j.msard.2019.06.019_bib0026","first-page":"S1","article-title":"Cyclic movement training of the lower limb in stroke rehabilitation","volume":"11","author":"Kamps","year":"2005","journal-title":"Neurol. Rehabil."},{"issue":"1","key":"10.1016\/j.msard.2019.06.019_bib0028","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/MRR.0b013e32833d6cdf","article-title":"Inter-rater reliability of the modified ashworth scale and modified modified ashworth scale in assessing poststroke elbow flexor spasticity","volume":"34","author":"Kaya","year":"2011","journal-title":"Int. J. Rehabil. Res."},{"issue":"9","key":"10.1016\/j.msard.2019.06.019_bib0029","doi-asserted-by":"crossref","DOI":"10.1016\/j.apmr.2013.04.020","article-title":"Effects of exercise training on fitness, mobility, fatigue, and health related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development","volume":"94","author":"Latimer-Cheung","year":"2013","journal-title":"Arch. Phys. Med. Rehabil."},{"issue":"5\/6","key":"10.1016\/j.msard.2019.06.019_bib0030","first-page":"239","article-title":"Forced exercise \u2013 effects of MOTOmed therapy on typical motor dysfunction in parkinson's disease","volume":"17","author":"Laupheimer","year":"2011","journal-title":"Neurol. Rehabil."},{"key":"10.1016\/j.msard.2019.06.019_bib0031","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1177\/0269215508095089","article-title":"An investigation into the agreement between clinical, biomechanical and neurophysiological measures of spasticity","volume":"22","author":"Malhotra","year":"2008","journal-title":"Clin. Rehabil."},{"key":"10.1016\/j.msard.2019.06.019_bib0032","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1212\/01.CON.0000433284.07844.6b","article-title":"General health issues in multiple sclerosis","volume":"19","author":"Marrie","year":"2013","journal-title":"Continuum"},{"key":"10.1016\/j.msard.2019.06.019_bib0033","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1016\/j.clinph.2006.04.019","article-title":"Plastic changes in the human H-reflex pathway at rest following skilful cycling training","volume":"117","author":"Mazzocchio","year":"2006","journal-title":"Clin. Neurophysiol."},{"key":"10.1016\/j.msard.2019.06.019_bib0034","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s10741-007-9053-y","article-title":"Central adaptations to exercise training in patients with chronic heart failure","volume":"13","author":"Mezzani","year":"2008","journal-title":"Heart Fail Rev."},{"key":"10.1016\/j.msard.2019.06.019_bib0035","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1191\/1352458502ms779oa","article-title":"Effects of a short-term exercise training program on an aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis","volume":"8","author":"Mostert","year":"2002","journal-title":"Mult. Scler."},{"key":"10.1016\/j.msard.2019.06.019_bib0036","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.neulet.2006.07.061","article-title":"Effect of acute leg cycling on the soleus H-reflex and modified ashworth scale scores in individuals with multiple sclerosis","volume":"406","author":"Motl","year":"2006","journal-title":"Neurosci. Lett."},{"key":"10.1016\/j.msard.2019.06.019_bib0037","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1080\/00207450600910671","article-title":"Effect of acute unloaded leg cycling on spasticity in individuals with multiple sclerosis using anti-spastic medications","volume":"117","author":"Motl","year":"2007","journal-title":"Int. J. Neurosci."},{"key":"10.1016\/j.msard.2019.06.019_bib0038","first-page":"487","article-title":"The benefits of exercise training in multiple sclerosis","volume":"8","author":"Motl","year":"2012","journal-title":"Neurol"},{"issue":"5","key":"10.1016\/j.msard.2019.06.019_bib0039","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1177\/1352458517690823","article-title":"Validity of the timed 25-foot walk as an ambulatory performance outcome measure for multiple sclerosis","volume":"23","author":"Motl","year":"2017","journal-title":"Mult. Scler. J."},{"key":"10.1016\/j.msard.2019.06.019_bib0040","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1152\/japplphysiol.01152.2009","article-title":"Time course and mechanisms of adaptations in cardiorespiratory fitness with endurance training in older and younger men","volume":"108","author":"Murias","year":"2010","journal-title":"J. Appl. Physiol."},{"key":"10.1016\/j.msard.2019.06.019_bib0041","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1191\/0269215503cr610oa","article-title":"A biomechanical investigation into the validity of the modified ashworth scale as a measure of elbow spasticity","volume":"17","author":"Pandyan","year":"2003","journal-title":"Clin. Rehabil."},{"issue":"4","key":"10.1016\/j.msard.2019.06.019_bib0042","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1002\/ana.410390405","article-title":"Impact of aerobic training on fitness and quality of life in multiple sclerosis","volume":"39","author":"Petajan","year":"1996","journal-title":"Ann. Neurol."},{"issue":"1\u20132","key":"10.1016\/j.msard.2019.06.019_bib0043","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1080\/09638280400014634","article-title":"Clinical scales for the assessment of spasticity, associated phenomena and function: a systematic review of the literature","volume":"27","author":"Platz","year":"2005","journal-title":"Disabil. Rehabil."},{"key":"10.1016\/j.msard.2019.06.019_bib0044","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.brainres.2009.06.063","article-title":"Aerobic fitness is associated with gray matter volume and white matter integrity in multiple sclerosis","volume":"1341","author":"Prakash","year":"2009","journal-title":"Brain Res."},{"issue":"2","key":"10.1016\/j.msard.2019.06.019_bib0045","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1152\/jn.1999.82.2.515","article-title":"Locomotor strategy for pedaling: muscle groups and biomechanical functions","volume":"82","author":"Raasch","year":"1999","journal-title":"J. Neurophysiol."},{"issue":"5","key":"10.1016\/j.msard.2019.06.019_bib0046","doi-asserted-by":"crossref","first-page":"545","DOI":"10.2522\/ptj.20060085","article-title":"Effect of aerobic training on walking capacity and maximum exercise tolerance in patients with Multiple Sclerosis: a randomized crossover controlled study","volume":"87","author":"Rampello","year":"2007","journal-title":"Phys. Ther."},{"key":"10.1016\/j.msard.2019.06.019_bib0047","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1038\/sj.sc.3100376","article-title":"The effects of therapy on spasticity utilizing a motorized exercise-cycle","volume":"35","author":"Rosche","year":"1997","journal-title":"Spinal Cord"},{"key":"10.1016\/j.msard.2019.06.019_bib0048","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s00421-012-2421-x","article-title":"Associations between Borg's rating of perceived exertion and physiological measures of exercise intensity","volume":"113","author":"Scherr","year":"2013","journal-title":"Eur. J. Appl. Physiol."},{"key":"10.1016\/j.msard.2019.06.019_bib0049","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1093\/brain\/122.1.141","article-title":"The psychometric properties of clinical rating scales used in multiple sclerosis","volume":"122","author":"Sharrack","year":"1999","journal-title":"Brain"},{"issue":"4","key":"10.1016\/j.msard.2019.06.019_bib0050","first-page":"327","article-title":"Effect of a 4 week period of unloaded leg cycling exercise on spasticity in multiple sclerosis","volume":"24","author":"Sosnoff","year":"2009","journal-title":"Neurorehabilit"},{"issue":"8","key":"10.1016\/j.msard.2019.06.019_bib0051","doi-asserted-by":"crossref","first-page":"674","DOI":"10.2340\/16501977-0397","article-title":"Functional electrical stimulation-assisted cycling of patients with multiple sclerosis: biomechanical and functional outcome\u2013a pilot study","volume":"41","author":"Szecsi","year":"2009","journal-title":"J. Rehabil. Med."},{"key":"10.1016\/j.msard.2019.06.019_bib0052","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1136\/jnnp.66.4.480","article-title":"Measuring change in disability after inpatient rehabilitation: comparison of the responsiveness of the bartel index and the functional independence measure","volume":"66","author":"Van der Putten","year":"1999","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"10.1016\/j.msard.2019.06.019_bib0053","series-title":"Human Physiology: the Mechanisms of the Body Functions","author":"Vander","year":"2001"},{"key":"10.1016\/j.msard.2019.06.019_bib0054","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/BF02260859","article-title":"A health-related quality of life measure for multiple sclerosis","volume":"4","author":"Vickrey","year":"1995","journal-title":"Qual. Life Res."},{"issue":"15","key":"10.1016\/j.msard.2019.06.019_bib0055","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.2165\/00007256-200434150-00005","article-title":"Exercise and multiple sclerosis","volume":"34","author":"White","year":"2004","journal-title":"Sports Med."},{"key":"10.1016\/j.msard.2019.06.019_bib0056","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1093\/occmed\/kqx063","article-title":"The Borg rating of perceived exertion (RPE) scale","volume":"67","author":"Williams","year":"2017","journal-title":"Occup. Med."},{"key":"10.1016\/j.msard.2019.06.019_bib0057","first-page":"1","article-title":"Disease modifying therapies for relapsing multiple sclerosis","volume":"354","author":"Wingerchuk","year":"2016","journal-title":"Br. Med. J."},{"issue":"1","key":"10.1016\/j.msard.2019.06.019_bib0058","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.kjms.2013.07.006","article-title":"Effect of biofeedback cycling training on functional recovery and walking ability of lower extremity in patients with stroke","volume":"30","author":"Yang","year":"2014","journal-title":"Kaohsiung J. Med. Sci."}],"container-title":["Multiple Sclerosis and Related Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034819302652?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034819302652?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:46:38Z","timestamp":1761900398000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2211034819302652"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9]]},"references-count":57,"alternative-id":["S2211034819302652"],"URL":"https:\/\/doi.org\/10.1016\/j.msard.2019.06.019","relation":{},"ISSN":["2211-0348"],"issn-type":[{"value":"2211-0348","type":"print"}],"subject":[],"published":{"date-parts":[[2019,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The effect of cycling using active-passive trainers on spasticity, cardiovascular fitness, function and quality of life in people with moderate to severe Multiple Sclerosis (MS); a feasibility study.","name":"articletitle","label":"Article Title"},{"value":"Multiple Sclerosis and Related Disorders","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.msard.2019.06.019","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Crown Copyright \u00a9 2019 Published by Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}]}}