Anatomical Concepts (UK)
Masters of Rehabilitation Engineering

Derek Jones: Anatomical Concepts (UK) Blog

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FES Cycling can build muscle mass after paralysis

We have known for decades that functional, electrically stimulated (FES) cycle training such as with the RehaMove FES bike can improve the cardiorespiratory fitness of spinal cord injured persons and others with neurological conditions such as MS, Parkinsons or recovering from a stroke. This is a massive benefit for long term health and fitness but what clients tend to notice is that their muscles get bigger - and that’s not a bad thing either.

In a typical FES Cycling session, the large muscle groups of the legs, arms, and shoulders are stimulated so that they contract and carry out useful exercise against resistance.

Client training with a RehaMove 2 FES Cycling system

Client training with a RehaMove 2 FES Cycling system

Our RehaMove FES Cycling system consists of the harmonised connection between a passive/active bike and the FES unit. Specific muscles are stimulated in sync with the movement of the pedals so that a paralysed individual can cycle using their own muscles actively.

If we were just to use the bike by itself (without FES) with a person with paralysis, they would be able to have their legs moved passively. This has some benefit but this would not result in cardiovascular fitness nor would muscles gain size and strength. FES Cycling has some 3.5 times the impact on the metabolism compared with using the bike alone. Also building and maintaining strength in the muscles helps to keep the bones strong and by increasing the blood circulation in the extremities we reduce the risk of pressure sores and minor cuts becoming slow to heal.

The ideas behind FES are far from new although we are still seeing new developments exploring the application of this technology. FES Cycling itself has been studied extensively since the 1980s and these products are now widely used at home, hospital and clinic around the world.

Fundamentally, as illustrated below, the electrical energy is delivered through surface electrodes placed on the muscle groups of interest. The energy flows between the electrodes and if the “energy is right” the nerves which make the muscle contract are activated. As you can understand, there is a lot of technical know-how that ensures this can be done safely and effectively.

The electrical energy that is delivered is typically described in terms of its pattern and what we call the stimulation parameters - Frequency, Pulse Width and Current. By varying these parameters the RehaMove system can create different effects - including making the muscles larger.

The fact is electrical stimulation literally “sculpts" muscle. The muscles and nerves respond to the stimulation and change their shape and structure in important ways.

The RehaMove approach to building muscle size and strength relies on the science of how muscle and nerve responds to stimulation. By varying the stimulation parameters you can choose whether you are aiming to increase muscle size or endurance for example.

The product design allows the user to control stimulation intensity easily and safely. Over time several centimeter increase in muscle girth is possible with major muscle groups.

If you are interested in learning more please contact us or review further details on this site or our specialist site at