FES cycling combines electrical stimulation of paralyzed muscles with a motorized ergometer to allow active exercise. It can benefit those with spinal cord injuries or other neurological conditions. Benefits include improved cardiovascular health, increased muscle and bone strength, and better feelings of well-being. Precise stimulation parameters are used and electrode positions are selected to safely activate specific muscles and allow cycling motions. Assessment is required to ensure no contraindications and to manage any risks.

1. Advanced Rehabilitation Technology
FES Cycling
Dr Derek Jones, PhD., MBA. !
Anatomical Concepts (UK) Ltd
with RehaMove from
Hasomed GmbH

2. Following a catastrophic injury
Part of your brain
tells you
you should feel the water!
..it’s just that you don’t.
Images- David Graham, “No Diving” ISBN 978-0-9557465-1-2

3. The GAP..!
TOO FEW will achieve their true
potential for rehabilitation following a
Catastrophic Injury
Due to
Limitin
g!
Attitud
es and
Beliefs!
Resour
ces!
KnowHow!
Comm
itment

4. l
o
o
lT
fu
e
S
E
F
A
-
s
U

5. FES Cycling
Combines a motorised ergometer with a
control system to deliver electrical
stimulation to muscle - allows active
exercise using the clients own paralysed
muscles

6. Who Can Benefit?
Spinal cord injury!
!
intact lower-motor neurons!
!
complete or incomplete!
MS, Parkinson’s & most !
Neurological Conditions!
Following catastrophic injury!

7. Benefits of FES Cycling
❖
Improved cardiovascular health!
❖
Increased muscle bulk in the legs!
❖
Increased bone density in the lower limbs!
❖
Reduction of spasticity in most cases!
❖
Lowered risk of pressure sores!
❖
Cosmetic benefits!
❖
Improved feelings of well being

8. Research Pedigree
❖
Extensive body of research!
❖
Supports FES Cycling as permitting a substantial
increase in a user’s exercise performance!
❖
Peak work rate, oxygen uptake, oxygen cost of work
done, ventilatory threshold!
❖
Most studies were of relatively low exercise intensity

9. Absolute Contraindications
❖
Unhealed fractures of the limbs to be stimulated!
❖
Pregnancy!
❖
Certain older cardiac pacemakers

10. Relative Contraindications
❖
Denervated muscles!
❖
Severe spasticity!
❖
Limited range of joint motion preventing cycling!
❖
Severe osteoporosis or > 5 years post injury!
❖
Damaged skin open wounds in the current path!
❖
Metal implants underneath areas to be stimulated

11. Cautions
❖
Uncontrolled autonomic dysreflexia!
❖
History of lower-limb fractures or joint injuries!
❖
Suspected or diagnosed epilepsy!
❖
Cardio-vascular diseases; tumours; suspected or
diagnosed heart problems!
❖
Implanted medical devices

12. Assessment Considerations
❖
Verify absence of absolute contraindications!
❖
Verify presence of relative contraindications and
cautions and assess risk!
❖
Identify any complicating factors!
❖
❖
leg length discrepancy? limited range of joint motion?
severe spasms? wheelchair type!
Client expectations!

13. FES Cycling system
RehaMove 2
Active arm and leg exercise!
8 channels - sufficient for practical
applications!
!
Versions for Adult - Paediatric and Bed/
Critical Care!
!
Can use the FES unit independent from
the MOTOmed

15. Applications
RehaMove Letto
Allows FES Cycling with unconscious
patients in critical care situations!
!
Reduce risk of intensive care syndrome

16. Stimulation Parameters
❖
Frequency - Varied and applied across all channels!
❖
Pulse width - Varied dynamically and automatically
during exercise between set limits!
❖
Current - adjusted for each muscle group

17. Stimulation Intensity
10 - 50 Hz in steps of 5 Hz
Frequency
0 to 130 mA
20 to 500 micro secs
Current
Pulse Width
Precisely
Controlled
Biphasic
rectangular!
impulses
Intensity of
Stimulation

18. Basic Electrode Positions

19. FES Applications
❖
Connect with other exercise
systems!
❖
FES rowing!
❖
Wound healing!
❖
Ventilator weaning via
abdominal muscle stimulation

20. 8-10 Dunrobin Court
Clydebank Business Park
Clydebank
G81 2QP
Tel: +44 141 952 2323
info@anatomicalconcepts.com
anatomicalconcepts.com