FES Cycling: How it elevates rehabilitation and fitness with 5 extraordinary benefits

Functional Electrical Stimulation (FES) bikes, or more formally referred to as FES Cycling systems, have emerged as a transformative device for rehabilitation and fitness, particularly following a neurological condition resulting in lower limb weakness or paralysis. They have been shown to be effective for long term fitness following a spinal cord injury, stroke, MS and other neurological conditions.

In the sixteen years we have worked with these products at Anatomical Concepts, it is most often those with spinal cord injuries that have been able to adopt them. due to the finance that can become available following an accident. This is a pity as all neurological conditions could benefit.

These bikes utilise electrical impulses to stimulate muscle contractions and thereby pedal a bike activity. This enables individuals with mobility impairments to exercise leg muscles actively and enhance their overall well-being. In this article, we delve into the top five advantages of employing FES bikes in long term rehabilitation. Here is a short video introduction.

If you prefer an audio introduction this is here

Improved Muscle Strength and Endurance

Neurological conditions will affect the person's ability to consciously contract and control their muscles. This partial or complete paralysis may mean the person must use a wheelchair and even this is not ideal for long term health. One of the biggest benefits of using FES bikes is the improvement in muscle strength and endurance. We all understand that if we do not or cannot exercise, our muscles will become weaker, lose size and over the long term this has metabolic consequences; bone health deteriorates and we can become more prone to diabetes and related conditions.

A RehaMove 2 FES bike based on the MOTOmed Muvi

By stimulating the leg muscles to contract with electrical impulses, FES bikes can help individuals to exercise actively and build strength in their legs. despite paralysis.

Additionally, as we will learn, FES bikes can help to improve cardiovascular fitness, which can have a range of health benefits.

Increased Range of Motion and Flexibility

The benefits of utilising FES bikes for rehabilitation and fitness extend to enhancing the range of joint motion and flexibility.

Through the contraction of muscles synchronised with the pedalling of the bike, the FES bikes are capable of preserving or augmenting the joint's range of motion and boosting flexibility. This proves particularly advantageous for individuals suffering from conditions like spinal cord injury, cerebral palsy or stroke, which often lead to muscle stiffness or spasticity. The lack of normal flexion and extension of legs due to being seated in a wheelchair can result in contractures and movement limitations, which, once established, pose a challenge to resolve. Regular use of an FES bike aids in maintaining the normal range of motion in the knees, hips, and ankles.

For those without complete paralysis and with prospects to walk again FES bikes can enhance overall mobility, consequently facilitating daily activities.

Promoting Cardiovascular Wellbeing

One of the primary advantages of utilising FES bikes for rehabilitation and fitness is the enhancement of cardiovascular health for the long run. The FES bikes provide an exercise regime that is of low impact, leading to improved blood circulation and peripheral flow, consequently reducing the risk of heart ailments and other cardiovascular disorders. Furthermore, FES bikes can bolster endurance and stamina, which can enhance overall fitness and the quality of life. Whether you are on the road to recovery from an injury or seeking to augment your fitness in spite of a chronic disease, FES bikes serve as an excellent tool to sustain or strengthen your cardiovascular well-being.

Reduced Pain and Swelling.

A key advantage of utilising FES bikes in rehabilitation for certain users is the potential to lessen pain and swelling (oedema) in the limbs. By enhancing circulation, FES bikes can decrease inflammation and fluid build-up. This proves particularly beneficial for those recovering from injuries or surgical procedures, as it can expedite the healing process and lessen discomfort. Furthermore, as previously mentioned, FES bikes assist in improving joint mobility and flexibility, which can thereby contribute to alleviating muscle and joint stiffness and pain.

Improved Mental Health and Well-Being.

IIn addition to the evidence-based, physical benefits, using FES bikes can also have a positive impact on mental health and well-being. Exercise has been shown to release endorphins, which are natural mood boosters that can help to reduce stress and anxiety. For individuals recovering from injuries or illnesses, the ability to exercise and improve their physical health can also have a positive impact on their mental health and overall well-being. FES bikes can provide a safe and effective way to exercise, even for individuals with limited mobility or other physical limitations.

How does an FES bike work?

Electrodes are placed on the muscle groups to be involved in the exercise

There are a number of FES Cycling brands and they all rely on the same principles but will implement these in a variety of ways. We have worked with the RehaMove system over a number of generations and it has proved to be one of the most popular models on the market.

For the electrical stimulation to work, electrodes are placed on the muscle groups to be involved in the exercise. For the legs these may include the major muscles of the thighs, hips and lower legs.

In their basic form, FES bikes rely on using FES (Functional Electrical Stimulation) to trigger useful contractions of the muscles of the legs as the pedals rotate. This effect, of using small, controlled amounts of electricity to produce muscle contractions has been known for many years. Small surface electrodes are placed on the muscle groups being trained and typically electrode cables connect these electrodes to an FES unit. The FES unit may be integral to the bike, or be an individual unit mounted on the bike as with our present RehaMove system.

What makes FES bikes special is the fact that the FES signals are synchronised with the movement of the bike pedals. Most FES bikes use a passive/active bike that is capable of moving a person's legs passively as it has a built-in motor.

Passive motion is commonly used in rehabilitation and is better than nothing, but by delivering synchronised FES to leg muscles at the correct time, the user can exercise actively - even if their legs are paralysed. Some models of FES bikes can also support similar exercises of the arms and shoulders where arm movements are supported with FES. We have clients who have high-level spinal cord injuries (paralysed arms and even ventilated) using a RehaMove FES bike that supports arm exercise with FES.

In our work with FES Cycling we setup the product for each individual and train the individual and or their care team to make adjustments over time. The stimulator we use can also be used to support other forms of exercise; enabling custom programmes to be created for whatever is unique about a client.

The most important thing to understand about exercise is that we have to stick at it. It is something that we have to commit to for life, and should not be viewed as something which is a short term fix. All humans ideally need to exercise but this becomes even more important when an injury or condition forces us to adopt a more or less passive lifestyle. An FES Cycling system at home allows us a means of exercising safely and effectively despite our health condition.

One of our client’s Claire Lomas discusses her use of FES Cycling in this short video

Conclusion

We have described 5 common reasons for people choosing to use FES Cycling systems. We have worked with FES Bikes for more than fifteen years and many users work with this technology in homes, hospitals and clinics around the world.

Overall, FES bikes represent a safe and effective way of exercising at home despite limb paralysis or weakness. Users see the benefit of preserving their health to the greatest degree so that potentially they may be better placed to take advantage of future breakthroughs in rehabilitation or curative steps that might arise in time. Whilst, as with any medical product, there are indications and contraindications for use, FES Cycling is safe and effective for the vast majority of neurological cases.

Please contact us for details if you would like a home demonstration (UK only) and details of options and pricing