Functional Electrical Stimulation, or FES for short, is a very powerful tool in the hands of a capable therapist but is sadly still poorly understood and less often seen in clinical practice than it deserves. I think there are a number of reasons for this.
The first problem is perhaps the fact that using electrical energy for therapeutic effect has a long and sometimes colourful history. This may have led to the whole idea of using electricity as being associated with “quackery”.

Another problem has perhaps been the fact that FES requires some technical as well as clinical know-how. It should be obvious that the nature and form of the electrical energy should be well understood as this is necessary for safe and effective application. This is not helped by the fact that there is no consistent use of terminology and practical guidance is often lacking about evidence supporting it’s use.

Today the wheelchair is one of the most, if not the most, commonly used assistive device for the personal mobility of people with disabilities. I suspect that, throughout history, wheelchairs have often been seen as a source of frustration, and a necessary evil; something that no one actually wanted to use. What matters though is that we consider a wheelchair just like any object we design - within the context of it’s use. We can’t judge the product design in isolation from it’s functional use in the environment and the ambitions of the user. We look at how robotics has allowed a rethink of products for standing and moving.

Contractures resulting in an equinus deformity are commonly seen in many patients in critical care, neurological, spinal cord injury and the vascular wards. Muscle imbalance across the structures of the foot and ankle can quickly result in a deformity. The foot is a complex dynamic structure that adapts to the loads placed on it; shaped by the nature of the muscles, ligamentous and bony structures. We must understand the particular risks presented by the features of each condition when thinking of a remedy. It should be obvious, for example, that tissue viability must be considered in each case alongside the biomechanics of deformity correction. The 654 DDA Orthosis is a simple to use dynamic orthosis that has been proven to be an effective solution to halt and even reverse this condition.

The Tek RMD combines the ability to stand with the ability to move in a unique way that is suitable for many people who have lower limb paralysis or weakness. In this article we will look at some essential facts about this “robotic mobility device”.

In this article, we look at the efficiency of FES Cycling and see that there is actually lots of room for improvement when it comes to metabolic efficiency and power output.

Of course that does not mean that they should not be used. Much research over decades shows the benefits for users from regular training. FES Cycling performance is good enough to produce results if people use these products. The benefits are greater than those via passive cycling alone.

However, any engineer who looks closely at the technology will realise that there is much that can be improved when it coms to FES cycling exercise. This is what engineering aims to do - refine and improve things for the benefit of society. Improving the technology could produce a greater health benefit for the same or less effort so it's worth striving for. It should also be said that this is no trivial challenge. All electro-mechanical systems that interact with the human body tend to offer design difficulties that are not obvious to the casual observer.

Combining a passive/active exercise bike with synchronised FES (Functional Electrical Stimulation) is a well-researched and well-known exercise modality for persons to use after a spinal cord injury or other neurological condition.  One of the benefits often sought by our spinal cord injured clients is preservation of bone density and we will look at the evidence for this in this article. Bone is a dynamic tissue - it responds to the needs placed upon it - getting stronger under load and weaker in the absence of load. Paralysis after a spinal cord injury and lack of activity that loads the bones results in a loss of bone strength and increased risk of fractures.. FES Cycing is one way of helping to prevent this.