Advanced Rehabilitation Technology
FES Cyclingwith RehaMove from Hasomed GmbH
Dr Derek Jones, PhD., MBA. !Anatomical Concepts (UK) Ltd
Following a catastrophic injury
Part of your brain tells youyou should feel the water!..it’s just that you don’t.
Images- David Graham, “No Diving” ISBN 978-0-9557465-1-2
The GAP..!TOO FEW will achieve their true
potential for rehabilitation following a Catastrophic Injury
Due to Limiting !Attitudes and Beliefs!Resources!Know-How!Commitment
FES - A Use
ful Tool
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
Who Can Benefit?
Spinal cord injury!! intact lower-motor neurons!! complete or incomplete!MS, Parkinson’s & most !Neurological Conditions!Following catastrophic injury!
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
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
Absolute Contraindications
❖ Unhealed fractures of the limbs to be stimulated!
❖ Pregnancy!
❖ Certain older cardiac pacemakers
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
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
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!
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
Applications
RehaMove Letto
Allows FES Cycling with unconscious patients in critical care situations!!Reduce risk of intensive care syndrome
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
Stimulation Intensity
Intensity of Stimulation
Frequency Current Pulse Width
10 - 50 Hz in steps of 5 Hz 0 to 130 mA 20 to 500 micro secs
Precisely Controlled Biphasic
rectangular!impulses
Basic Electrode Positions
FES Applications
❖ Connect with other exercise systems!
❖ FES rowing!
❖ Wound healing!
❖ Ventilator weaning via abdominal muscle stimulation
8-10 Dunrobin Court Clydebank Business Park
Clydebank G81 2QP
Tel: +44 141 952 2323 [email protected]
anatomicalconcepts.com
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