How to prepare a person with complete spinal cord injury to use surface electrodes for FES trike cycling

Abstract

Functional Electrical Stimulation (FES) cycling could benefit people with Spinal Cord Injury (SCI). The FES cycling involves large muscle groups during the training, and thus improves the cardiovascular function, increases the muscle bulk and reduces the secondary complications. This study developed an outdoor FES exercise cycling system for complete SCI persons to exercise their lower limbs without putting extra load on upper extremities. The mechanical structure of the cycling system was specially redesigned to secure the SCI persons in the cycling system. A six-phase-angle-driven control algorithm was designed to stimulate the quadriceps and hamstrings muscles. Two training modes, i.e., continuous mode and on-off mode, were designed and tested to increase the duration of the electrical stimulation to reduce muscle fatigue. A complete SCI volunteer participated in this training for six months. Beneficial effects could be observed such as paralyzed lower limb muscles had regained the muscle mass and reduced edema from the improved blood circulation. Moreover, the SCI volunteer attended the Cybathlon FES-bike competition in Zurich in October 2016 with Team Phoenix from the CUHK.

Contributions of the Cybathlon championship to the literature on functional electrical stimulation cycling among individuals with spinal cord injury: A bibliometric review

“…The increase in publications in 2017 ( Fig. 3 ) was because of the studies published from the Cybathlon participating teams ( n = 13) in that year, 6 , 8 , 18 , 22 , 23 , 33 , 34 , 35 , 36 , 37 , 39 , 40 , 41 as shown in the findings from the present study ( Table 1 ). Because the Cybathlon championship encouraged the exchange of information among people with disabilities, the general public, researchers, and developers of equipment, 43 the blending of technology and clinical neurorehabilitation science gained vast attention and thus contributed to the increase in the number of studies.…”

“…With the exception of work by Guimarães et al, 33 the authors were unable to determine whether “subjects asked to participate in the study were representative of the entire population from which they were recruited” (Criterion 11) and “those subjects who were prepared to participate were representative of the entire population from which they were recruited” (Criterion 12). The authors of the studies were unable to determine whether “losses of patients to follow up taken into account” (Criterion 26), with the exception of Guimarães et al, 33 Leung et al, 35 and Tong et al, 36 where the criterion was not applicable.…”

“…1 ), and only 27.5% of the Cybathlon studies were included in the study quality assessment. 6 , 8 , 22 , 23 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 The low number of the Cybathlon studies included in the assessment of study quality was because duplicate titles were removed from the search of the 5 databases. Based on D&B criteria checklist 31 ( Supplementary Table 1 ), only open access, full-length articles and conference proceedings were appropriate for the quality assessment.…”

“…MOTOmed (Reck-Technik GmbH & Co. KG Medizintechnik, Betzenweiler, Germany) and BerkelBike (BerkelBike BV, Sint-Michielsgestel, the Netherlands) are the commercialized FES-assisted cycling ergometers that are widely used in rehabilitation industries. 45 Our review revealed that Cybathlon studies were conducted in many different locations, including Asian countries, 18 , 35 , 36 , 39 South American countries, 18 , 45 the United States, 6 , 18 , 37 Switzerland, 8 , 18 , 46 Australia, 18 England, 23 and Serbia. 22 The wide geographical distribution of Cybathlon studies indicates that FES-evoked cycling is well-researched throughout the world and well-accepted among people with disabilities across different cultures.…”

“…The articles cited were authored by the participating teams in 2017 8 , 18 , 22 , 23 , 33 , 34 , 35 , 37 , 39 , 40 , 41 , 45 , 46 and describe various aspects of the race, including information on the pilots, stimulation strategies, bike details, and training programs. 37 The other types of publications, such as papers from proceedings, 36 , 42 book chapters, 45 editorial material, 6 and reviews, 47 were published in similar quantities.…”