Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2017 Nov 17;14(1):118.
doi: 10.1186/s12984-017-0326-y.

Setting the pace: insights and advancements gained while preparing for an FES bike race

John McDaniel  1   2 , Lisa M Lombardo  3 , Kevin M Foglyano  3 , Paul D Marasco  3   4 , Ronald J Triolo  3   5
Affiliations
Clinical Trial

Setting the pace: insights and advancements gained while preparing for an FES bike race

John McDaniel et al. J Neuroeng Rehabil. .

Abstract

The reduction in physical activity following a spinal cord injury often leads to a decline in mental and physical health. Developing an exercise program that is effective and enjoyable is paramount for this population. Although functional electrical stimulation (FES) stationary cycling has been utilized in rehabilitation settings, implementing an overground cycling program for those with spinal cord injuries has greater technical challenges. Recently our laboratory team focused on training five individuals with compete spinal cord injuries utilizing an implanted pulse generator for an overground FES bike race in CYBATHLON 2016 held in Zurich, Switzerland. The advancements in muscle strength and endurance and ultimately cycling power our pilots made during this training period not only helped propel our competing pilot to win gold at the CYBATHLON 2016, but allowed our pilots to ride their bikes outside within their communities. Such a positive outcome has encouraged us to put effort into developing more widespread use of FES overground cycling as a rehabilitative tool for those with spinal cord injuries. This commentary will describe our approach to the CYBATHLON 2016 including technological advancements, bike design and the training program.

Keywords: CYBATHLON; Cycling; exercise; Functional electrical stimulation; Spinal cord injury.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

All procedures were approved the IRB at the Cleveland Louis Stokes Veterans Affairs Medical Center. All subjects signed consent to participate forms.

Consent for publication

Subjects provided their consent to publish their pictures and data.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Picture of the modified trike with ECU on the seat. Note the ankle immobilizers were utilized to lock out the ankle. The insert illustrates the gear on the crank arm which is attached to the encoder that provides crank position to the ECU
Fig. 2
Fig. 2
Stimulation patterns for the 5 pilots trained during this project. 0 degrees labels the position in which the right leg is fully flexed and begins to extend in the clockwise direction (as indicated by the black arrow). 180 degrees labels the position in left leg is fully flexed and begins to extend. Muscle abbreviations: R and L refer to right and left, Quad- quadriceps muscle group, AM- posterior portion of adductor magnus, GM- gluteus maximus, HS- hamstrings (with an emphasis on semimembranosus)
Fig. 3
Fig. 3
Power profile curves for two pilots across the training period. Note some data was dropped during the August test for pilot 1
Fig. 4
Fig. 4
Two pilots performing a time trial prior to the CYBATHLON
Fig. 5
Fig. 5
Improvements in 750 m time trial performance for two pilots
Fig. 6
Fig. 6
Picture of our pilot with the gold medal from the CYBATHLON
Fig. 7
Fig. 7
Picture of one of our pilots cycling near Half Dome in Yosemite National Park, California
See this image and copyright information in PMC

References

    1. Phillips AA, Krassioukov AV. Contemporary cardiovascular concerns after spinal cord injury: mechanisms, Maladaptations, and management. J Neurotrauma. 2015;32(24):1927–1942. doi: 10.1089/neu.2015.3903. - DOI - PubMed
    1. Williams R, Murray A. Prevalence of depression after spinal cord injury: a meta-analysis. Arch Phys Med Rehabil. 2015;96(1):133–140. doi: 10.1016/j.apmr.2014.08.016. - DOI - PubMed
    1. Davis JA, Jr, Triolo RJ, Uhlir J, Bieri C, Rohde L, Lissy D, Kukke S. Preliminary performance of a surgically implanted neuroprosthesis for standing and transfers--where do we stand? J Rehabil Res Dev. 2001;38(6):609–617. - PubMed
    1. Bieri C, Rohde L, Danford GS, Steinfeld E, Snyder S, Triolo RJ. Development of a new assessment of effort and assistance in standing pivot transfers with functional electrical stimulation. J Spinal Cord Med. 2004;27(3):226–235. doi: 10.1080/10790268.2004.11753753. - DOI - PubMed
    1. Triolo RJ, Bailey SN, Lombardo LM, Miller ME, Foglyano K, Audu ML. Effects of intramuscular trunk stimulation on manual wheelchair propulsion mechanics in 6 subjects with spinal cord injury. Arch Phys Med Rehabil. 2013;94(10):1997–2005. doi: 10.1016/j.apmr.2013.04.010. - DOI - PMC - PubMed