Coma patients cycle!

[TourOfSardinia]

http://www.bbc.com/news/uk-england-hampshire-26482399

Critically ill patients at Portsmouth's Queen Alexandra Hospital are being put on an exercise bike to help speed up their recovery.

In trials, some have cycled up to three miles a day while they are still in intensive care.

The bike can even be used by patients in a coma.

perhaps Schumacher (bless him) might try the bike.

 

[RedheadDane]

Okay, I understand how that lady could use the bike.
But a patient who's in a coma?
How?

 

[FrankDay]

Okay, I understand how that lady could use the bike.
But a patient who's in a coma?
How?

Once it is started it is a spinal reflex action, no thinking required.

 

[elapid]

Cycling is not a spinal reflex. Watch the video. They are strapped on to the cycling machine and for those that cannot generate the peer to cycle themselves, such as those in a coma, then the motor cycles for them.

 

[FrankDay]

Cycling is not a spinal reflex. Watch the video. They are strapped on to the cycling machine and for those that cannot generate the peer to cycle themselves, such as those in a coma, then the motor cycles for them.

Sure cycling is a spinal reflex just as walking is. The brain can override and is necessary to start, stop, and determine intensity. But, to do the motion, once learned, it becomes a reflex activity requiring no cerebral control.

 

[elapid]

Sure cycling is a spinal reflex just as walking is. The brain can override and is necessary to start, stop, and determine intensity. But, to do the motion, once learned, it becomes a reflex activity requiring no cerebral control.

Watch the video and listen to the commentary. The answer to RedheadDane's question is plainly stated.

As a physician and anesthetist, Frank, you need to brush up on your the definition of reflex (involuntary) and voluntary actions:

A spinal reflex is an involuntary, spontaneous action over which you have no control; it is not a learned behaviour; and it occurs at the spinal cord level without cerebral involvement.

Walking is a voluntary, conscious and deliberate action; it is a learned action; and it is controlled by the brain and the cerebellum, not the spinal cord. If walking was a reflex then babies would be born walking and paraplegics would be able to walk despite their spinal cord injuries (ditto for cycling).

 

[FrankDay]

A spinal reflex is an involuntary, spontaneous action over which you have no control; it is not a learned behaviour; and it occurs at the spinal cord level without cerebral involvement.

Phooey. I stand by my training. Walking is a spinal reflex action despite the fact that we do exert higher control over some aspects of it. Let me know when you have graduated from medical school and have some creds to object.

 

[elapid]

Phooey. I stand by my training. Walking is a spinal reflex action despite the fact that we do exert higher control over some aspects of it. Let me know when you have graduated from medical school and have some creds to object.

Well, if you stand by your training, I am glad you no longer practice.

As a veterinarian and specialist small animal surgeon dealing with neurosurgery every day, I am as or more qualified than you to know the difference between automatic involuntary reflexes and learned voluntary actions (e.g., walking and cycling).

Perhaps you need to brush up on the definition of spinal reflexes and voluntary actions, such as walking and cycling, considering you have not practiced medicine for 20+ years. Try a dictionary or Google. You may learn something.

Again, reflexes are involuntary and mediated at the level of spinal cord; walking and cycling are voluntary and mediated at the level of the cerebrum and cerebellum. If there is any higher control, such as there is with walking and cycling, then it is not a reflex. If you state otherwise, which no doubt you will because you have not shown the ability to admit when you are wrong, then you are foolishly stubborn to your own detriment.

Here is a good article on the neurological control of walking, note no mention that walking is a spinal reflex: http://www.oandp.org/jpo/library/1990_01_001.asp

And here is some information on reflexes, note no mention of walking or cycling as a reflex:
http://en.wikipedia.org/wiki/Reflex
http://neurology.about.com/od/NervousSystem/a/What-Is-A-Reflex.htm

 

[FrankDay]

Well, if you stand by your training, I am glad you no longer practice.

As a veterinarian and specialist small animal surgeon dealing with neurosurgery every day, I am as or more qualified than you to know the difference between automatic involuntary reflexes and learned voluntary actions (e.g., walking and cycling).

Perhaps you need to brush up on the definition of spinal reflexes and voluntary actions, such as walking and cycling, considering you have not practiced medicine for 20+ years. Try a dictionary or Google. You may learn something.

Again, reflexes are involuntary and mediated at the level of spinal cord; walking and cycling are voluntary and mediated at the level of the cerebrum and cerebellum. If there is any higher control, such as there is with walking and cycling, then it is not a reflex. If you state otherwise, which you will no doubt will because you have not shown the ability to admit when you are wrong, then you are foolishly stubborn to your own detriment.

Here is a good article on the neurological control of walking, note no mention of spinal reflexes: http://www.oandp.org/jpo/library/1990_01_001.asp

And here is some information on reflexes, note no mention of walking or cycling as a reflex:
http://en.wikipedia.org/wiki/Reflex
http://neurology.about.com/od/NervousSystem/a/What-Is-A-Reflex.htm

The walking and cycling and running (and many other) coordinations are not simple dermatomal leval spinal reflexes, such as the knee jerk when the doctor taps the patellar tendon because it involves the cerebellum. (that having been said a simple reflex, such as the crossed extensor reflex, could be involved.) Yes, it is learned but it is not under conscious control (except as the consciousness part of the brain initiates, stops, or modifies the basic pattern) and works just fine as long as the spinal cord/cerebellum is intact. Yes, it is learned but it doesn't require conscious effort to learn, otherwise toddlers would never learn to walk. We learn these patterns through trial and error when young and once ingrained they are very, very, difficult to change.

If, in fact,brain functioning is required to walk perhaps, as a veterinarian, you can explain how it is chickens run around for awhile after having their heads lopped off.

The original question was how would it be possible for a person in a coma could pedal. I simply stated I thought it possible as pedaling doesn't require thinking as the entire process is controlled at the spinal cord / cerebellum level. Perhaps spinal reflex wasn't the best word. Let's instead use the term spinal/cerebellar level coordination, no thinking required.

from your article: "Primitive walking reflexes occur at the midbrain and subthalamic levels. "

 

[elapid]

The walking and cycling and running (and many other) coordinations are not simple dermatomal leval spinal reflexes, such as the knee jerk when the doctor taps the patellar tendon because it involves the cerebellum. (that having been said a simple reflex, such as the crossed extensor reflex, could be involved.) Yes, it is learned but it is not under conscious control (except as the consciousness part of the brain initiates, stops, or modifies the basic pattern) and works just fine as long as the spinal cord/cerebellum is intact. Yes, it is learned but it doesn't require conscious effort to learn, otherwise toddlers would never learn to walk. We learn these patterns through trial and error when young and once ingrained they are very, very, difficult to change.

If, in fact,brain functioning is required to walk perhaps, as a veterinarian, you can explain how it is chickens run around for awhile after having their heads lopped off.

The original question was how would it be possible for a person in a coma could pedal. I simply stated I thought it possible as pedaling doesn't require thinking as the entire process is controlled at the spinal cord / cerebellum level. Perhaps spinal reflex wasn't the best word. Let's instead use the term spinal/cerebellar level coordination, no thinking required.

from your article: "Primitive walking reflexes occur at the midbrain and subthalamic levels. "

So, yep, you were wrong. Thanks for admitting it. You stated walking and cycling were spinal reflexes, and so no we are not going to use the term spinal/cerebellar level coordination to gloss over the fact that you were wrong.

 

[FrankDay]

So, yep, you were wrong. Thanks for admitting it. You stated walking and cycling were spinal reflexes, and so no we are not going to use the term spinal/cerebellar level coordination to gloss over the fact that you were wrong.

Fine, the intent was to convey that the higher regions of the CNS are not necessary to do the basic activity, hence it could be possible for someone to pedal in a coma. Now if you could admit that your stating that it couldn't happen is also wrong.

Edit: BTW, if we use the definition of reflex that one gets when one googles for the definition

an action that is performed as a response to a stimulus and without conscious thought.

the only issue with my answer was walking/pedaling is not strictly a spinal reflex as the cerebellum is involved also.

 

[FrankDay]

Fine, the intent was to convey that the higher regions of the CNS are not necessary to do the basic activity, hence it could be possible for someone to pedal in a coma. Now if you could admit that your stating that it couldn't happen is also wrong.

Edit: BTW, if we use the definition of reflex that one gets when one googles for the definition the only issue with my answer was walking/pedaling is not strictly a spinal reflex as the cerebellum is involved also.

Heard this over the weekend. Perhaps pedaling and walking require less thinking (at least by the brain) and the spinal cord is more complicated than any of us realized. If those with severed spinal cords can potentially do it then, it seems, those who are unconscious could also. Stay tuned.