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FES Cycling is effective at boosting cardiovascular fitness following spinal cord injury and useful with many other conditions requiring rehabilitation. The presentation gives some basic background including contraindications, cautions and of course benefits
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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
