Planning an FES Cycling session with the RehaMove system

We recently put together a Pilot “FES Cycling Tune Up Course which is free for our clients who get an access code from us. The aim is to give more in-depth information on the background science as well as how to programme the RehaMove FES Cycling system for optimal usage.

I have included one of the videos from the course below. In this section, we are looking at planning a training session. It may seem that planning a training session is a bit complicated but through the course we aim to show you it's not rocket science.

In previous lessons of the Course we reveal that stimulation intensity depends upon three things - frequency, current and pulse width. We also learned that the energy is delivered to the muscles as a series of bipolar pulses of electricity. It is the width, height and frequency of these pulses that count.

The stimulation parameter “Frequency” produces different effects depending on the values selected in a programme.

The frequency of the stimulation can have a number of effects depending on its value. For example, higher frequencies, tend to build strength in the muscles being stimulated and lower frequencies can build endurance, help muscles to relax or assist with wound healing. If we want a strong, smooth, muscle contraction for FES Cycling we typically will need a frequency of 20 Hz or more to enable this. The frequency of stimulation being used, selectively activates certain muscle fibre types.

With respect to current and pulse width, from experience you can gain a good idea of the stimulation parameters that are going to be needed in a particular case. For example, for a person with complete spinal cord injury, we can expect to be using current values in the range 40 to 90 mA, and pulse width values in the range 250 to 500 µs.

For Stroke, Brain injury and incomplete spinal-cord injuries, sensation may limit strengths of contractions. We might then expect to use a lower intensity of stimulation because the user may well be able to contribute active cycling also.

In the video we explain the RehaMove FES Cycling systems use of reusable templates and how to customise these for individual use.

Planning an exercise sessions boils down to thinking about how often to exercise, how hard to exercise and for how long. Our baseline advice for FES Cycling has been to use sustainable active cycling three times per week against resistance. Typically for 20 to 40 minutes per session.

As you will learn in the video, session management can follow some general guidelines but ultimately needs to be fine tuned to the individual. For example, when leg spasms are a problem one strategy could be to lengthen the warm up period and add as small amount of FES during the warm up period. We don’t need to exercise intensively to get health benefits. Volume and persistence is what counts.