Evaluation of Functional Electrical Stimulation to Assist Cycling in Four Adolescents with Spastic Cerebral Palsy

Abstract

Introduction. Adolescents with cerebral palsy (CP) often have difficulty participating in exercise at intensities necessary to improve cardiovascular fitness. Functional electrical stimulation- (FES-) assisted cycling is proposed as a form of exercise for adolescents with CP. The aims of this paper were to adapt methods and assess the feasibility of applying FES cycling technology in adolescents with CP, determine methods of performing cycling tests in adolescents with CP, and evaluate the immediate effects of FES assistance on cycling performance. Materials/Methods. Four participants (12–14 years old; GMFCS levels III-IV) participated in a case-based pilot study of FES-assisted cycling in which bilateral quadriceps muscles were activated using surface electrodes. Cycling cadence, power output, and heart rate were collected. Results. FES-assisted cycling was well tolerated (n = 4) and cases are presented demonstrating increased cadence (2–43 rpm), power output (19–70%), and heart rates (4-5%) and decreased variability (8–13%) in cycling performance when FES was applied, compared to volitional cycling without FES assistance. Some participants (n = 2) required the use of an auxiliary hub motor for assistance. Conclusions. FES-assisted cycling is feasible for individuals with CP and may lead to immediate improvements in cycling performance. Future work will examine the potential for long-term fitness gains using this intervention.

Combination of Functional Electrical Stimulation and Noninvasive Spinal Cord Electrical Stimulation for Movement Rehabilitation of the Children with Cerebral Palsy

“…Functional electrical stimulation (FES) has been used to enhance the effect of locomotor training [15]. It was shown that in CP children FES assisted cycling or walking was tolerated well and resulted in increased muscle strength, balance improvement, normalization of biomechanical and innervation structure of locomotor act, increased cadence, power output, and heart rates [15,19].…”

Comparison of Muscle Stimulation Groups for Simplified Practical FES Cycling Control with Cycling Wheelchair: An Experimental Test with Healthy Subjects

“…Integration of electric motor assist and FES has also been studied for this purpose [8], [9]. In addition to using the FES cycling as a mobility device, application of FES cycling to motor rehabilitation has been studied [10]- [12]. For the rehabilitation purpose, many studies have used stationary FES cycling system such Copyright c 2016 The Institute of Electronics, Information and Communication Engineers as bicycle ergometer combined with FES [13]- [20].…”

Neurorehabilitation of patients with cerebral palsy

“…A course of FES during walking was shown to strengthen the paretic muscles, to improve peripheral circulation, to normalize the biomechanical and innervation structures of locomo tion, and to reduce the walking associated energy consumption. Harrington et al [53] assessed the feasi bility of applying FES cycling technology in adoles cents with CP and evaluated the immediate results of FES therapy performed during exercise on a cycling machine. FES assisted cycling was well tolerated and facilitated an increase in cycling cadence, power out put, and heart rate and a decrease in variability in cycling performance as compared with a control group without FES assistance during rehabilitation.…”