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

Ann Tokay Harrington,Calum G A Mcrae,Samuel C K Lee

doi:10.1155/2012/504387

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.

Highlights

Adolescents with cerebral palsy (CP) often have difficulty participating in exercise at intensities necessary to improve cardiovascular fitness
All participants were able to complete tests without difficulty and were able to tolerate the application of Functional electrical stimulation (FES) to bilateral quadriceps muscles
Functional electrical stimulation- (FES-)assisted cycling resulted in increased cadence, power output, and heart rates and decreased variability in cycling performance compared with volitional cycling without FES assistance

Summary

Introduction

Adolescents with cerebral palsy (CP) often have difficulty participating in exercise at intensities necessary to improve cardiovascular fitness. Cerebral Palsy (CP) is a nonprogressive disorder that results from a disturbance in the fetal or infant brain [1, 2]. This disturbance, varied in etiology, results in motor impairments in the developing child [3,4,5,6]. The weakness that affects these muscles results in balance impairments and poor selective motor control which may lead to diminished independence and a lack of physical activity [12, 13]. Traditional means of exercise, such as running, jumping, and playing organized sports, may be difficult for individuals with such functional limitations and, many individuals with disabilities participate in less physical activity than people without disabilities [16,17,18,19]

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