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Foot Electrical Stimulation Cycling

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Outlined below is a study that requires volunteers who wish to get healthier and have a spinal cord injury. This project has obtained a grant from the Engineering and Physical Sciences Research Council to examine “The development of FES systems for cycling: improving health after spinal cord injury.” Read the following outline from the Research Team and see if you are interested to helping further this unique Spinal Cord Injured project….

FES Functional Electrical Stimulation is the application of an electric current to a muscle or nerve to cause a muscle contraction. (In the project described below, the electrical stimulus is delivered to the muscle via electrodes placed on the skin over the muscle. No surgery is involved.)

FES has been around for a long time. It was first demonstrated by Galvani in the16th century and has been the subject of research in spinal cord injury since the 1960s. As the name implies the focus of most of the research has been directed at creating a function such as walking; there has been relatively little work in using FES to improve muscle bulk and health through exercise.
The results of past FES research have been a mixed bag. Whereas FES has been successful in restoring bladder function it has been less successful in restoring locomotor function. Despite considerable effort no one has succeeded in producing a FES walking ability that is anywhere near as functional as a wheelchair.

Researchers have carried out a number of research programmes that have involved “cycling” with FES in the laboratory. However none of these programs had the intention or result of enabling any spinally injured person being able to cycle the open road.

Functional electrical stimulation (FES) cycling:

* Has the potential to give the health benefits of exercise without excessive wear on shoulder joints.
* Builds up muscle bulk.
* Keeps joints mobile.
* May improve circulation.
* May minimise the tendency to develop pressure sores.
* May improve bone density.

Following successful pilot studies new larger scale trials are about to start in London and Glasgow to evaluate further the health benefits of FES cycling. The researchers would like to extend their database from which to choose the most suitable subjects for these and any future similar studies.

The research subjects will be expected to perform FES cycling or FES cycle training for an average of 1 hour five days a week for one year. The cycling and training would be done at home but subjects would occasionally have to travel to London or Glasgow for various health tests.

If you would like to be entered on the researchers’ database so that you could be considered for FES cycling research projects please e-mail Dr Fitzwater at roger@rfitzwater.freeserve.co.uk with the following information: your name, date of birth, date of injury, level of injury, whether incomplete or complete, address, e-mail, home, work and mobile phone numbers.

More information can be obtained from this article that first appeared in the August 2000 edition of Forward.


What’s it all about ? What’s it got to do with us ?!

Simple! Exercise promotes health, cycling is one of the best and healthiest forms of exercise and it is possible for the spinally injured to (leg) cycle using FES (Functional Electrical Stimulation). Want to know more? Then read on.

Exercise Adequate exercise is essential for good health. It protects against cardiovascular disease and other causes of illness and premature death. It improves fitness, maintains function and helps prevent obesity. It is a mood elevator and an effective treatment for mild to moderate Depression.

The benefits of exercise are subject to the law of diminishing returns; thus those that exercise the least, such as the disabled, have the most to gain from any exercise they are able to take.

But the “extra” benefit of exercise for us does not stop there. One of the worst thing is that can happen to a spinally injured person is to get a Pressure Sore. Pressure sores are now the commonest cause of death directly related to spinal cord injury. They can lead to many months in hospital, often in isolation because of infection. Lack of muscle bulk and poor circulation in the lower limbs are contributory factors to the development of to pressure sores. FES exercise increases muscle bulk and improves circulation. There is also reason to believe that FES cycling may have beneficial effects on Osteoporosis and joint contractures.

Why FES cycling? Unlike walking the muscle actions required to cycle are repetitive and relatively simple. An increasing variety of suitable cycle formats (recumbents) are becoming available and the government is encouraging the development of safe cycling infrastructure. Cycling is a useful and, most importantly of all, a very enjoyable activity.

What has been achieved so far? I have been working on a FES cycling research programme with a team from University College London. We have been working with extremely limited resources and yet have had a great deal of success.

I have an incomplete Paraplegia at T12. Before I started the FES cycle programme I could only rotate the pedals of a cycle through half of one revolution. After a year training about an hour every third day I could cycle 13 km and my voluntary power has increased so much that I can cycle a significant distance without FES.

The voluntary strength in my right leg has increased by 45% and I now have movement in my left leg whereas previously I had none. The power I can produce with FES has increased by 40%. The muscle bulk of the stimulated muscles has increased by 21%. I have lost weight and my wife tells me that I’m less like Victor Meldrew. I have noted small but significant improvements in my abilities to walk, transfer, swim etc.

We hope to make FES cycling a practical proposition for most spinal cord injured people who would wish to do it. Resources permitting we hope to expand our programme to include more subjects.

Dr Roger Fitzwater

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