Cycling for children with neuromuscular impairments using electrical stimulation—Development of tricycle-based systems

McRae, C.G.A.; Johnston, T.E.; Lauer, R.T.; Tokay, A.M.; Lee, S.C.K.; Hunt, K.J.

doi:10.1016/j.medengphy.2008.12.005

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Volume 31, Issue 6 , Pages 650-659, July 2009

Cycling for children with neuromuscular impairments using electrical stimulation—Development of tricycle-based systems

C.G.A. McRae
- Shriners Hospitals for Children Philadelphia, 3551 N. Broad Street, Philadelphia, PA 19140, USA
- Corresponding author.
T.E. Johnston
- Shriners Hospitals for Children Philadelphia, 3551 N. Broad Street, Philadelphia, PA 19140, USA
- University of Sciences in Philadelphia, Philadelphia, PA, USA
R.T. Lauer
- Shriners Hospitals for Children Philadelphia, 3551 N. Broad Street, Philadelphia, PA 19140, USA
- Temple University, Department of Physical Therapy, Philadelphia, PA, USA
A.M. Tokay
- University of Delaware, Biomechanics and Movement Science Program, Newark, DE, USA
S.C.K. Lee
- Shriners Hospitals for Children Philadelphia, 3551 N. Broad Street, Philadelphia, PA 19140, USA
- University of Delaware, Department of Physical Therapy, Newark, DE, USA
K.J. Hunt
- Centre for Rehabilitation Engineering, University of Glasgow, Glasgow, UK
- Scottish Centre for Innovation in Spinal Cord Injury, UK¹

Received 19 August 2008; received in revised form 20 November 2008; accepted 27 December 2008. published online 05 February 2009.

Abstract

Aim

Cycling using functional electrical stimulation (FES-cycling) is a well defined exercise method for adults with spinal cord injury (SCI). Although little studied thus far, FES-cycling also has the potential to offer a means of exercise to pediatric populations, such as SCI or cerebral palsy (CP), that presently have few alternative options. The primary aim of this study was to develop FES-cycling equipment and methods which can meet the differing needs of children with SCI and CP.

Methods

Design criteria were determined based on key considerations for pediatric FES-cycling. Two separate prototype systems for training/recreation and laboratory-based research were built to meet these specifications. To experimentally verify the equipment, FES-cycling tests involving one child with motor complete SCI and one child with diplegic spastic CP were performed using the laboratory system.

Results

Experimental verification indicated that FES-cycling experiments involving children with SCI and CP are feasible provided that accurate measurement of both propulsive and resistive torque is achieved. Specific seating and orthotic needs for each subject population were met by both systems.

Conclusion

The FES-cycling systems described here may assist in future investigations of pediatric FES-cycling performance and novel exercise regimes designed specifically for children.

Keywords: FES-cycling, Spinal cord injury, Cerebral palsy, Pediatric, Instrumented cycle