FAQs – FES Cycling After Paralysis

FES rehabilitation tools are becoming more and more commonly relied on by those affected by paralysis.

72% of the people living with paralysis documented in the 2013 US Paralysis Prevalence & Health Disparities Survey were under 65. Similarly, the average age of people with Spinal Cord Injury (SCI) is 42, and the average onset age for MS is around 29. Further, several causes of paralysis are congenital, such as spina bifida or cerebral palsy. With so many younger populations affected, those physically active before their paralysis may question how to maintain their health and safely engage in therapeutic exercise. 

Research shows the importance of movement as soon and often as possible following paralysis, as immobility can lead to muscle atrophy, bone demineralization, skin degradation, and metabolic disorders, including diabetes, stroke, and heart attack. But, immediate and consistent exercise helps prevent or reverse these secondary conditions. Cycling with functional electrical stimulation (FES cycling) to activate weak or paralyzed muscles effectively achieves therapeutically significant exercise, despite paralysis. If you live with paralysis, you likely have many questions about FES rehabilitation and whether it is right for you. Read on to learn answers to some of the most commonly asked questions. 

What is FES?

FES is Functional Electrical Stimulation. FES is applied through electrodes placed over or implanted under the skin to stimulate motor neurons and elicit contractions of paralyzed or weakened muscles. FES is used to produce a functional movement, like standing or cycling, to maximize stimulation benefits and encourage nervous system recovery or repair. 

What is a FES Cycle?

FES cycles are medical devices that enable people with paralysis or weakness to participate in cycling for therapeutic exercise. FES cycles are typically equipped with an electric motor to assist or resist the rider, as needed. FES cycles apply stimulation to weak or paralyzed muscles, and the FES is computer-controlled to synchronize with the pedaling motion and stimulate each muscle group at the right time.  MYOLYN’s FES cycling device, the MyoCycle, specifically targets muscles in the lower extremities, such as the hamstrings, quadriceps, and glutes.

Who Can Do FES Cycling?

FES cycling is beneficial for people living with paralysis caused by stroke, multiple sclerosis (MS), Parkinson’s disease, traumatic brain injury, spinal cord injury, Familial Spastic Paraplegia (FSP), cerebral palsy, and other disorders. 

  People with any of the following contraindications should not do FES cycling:

• Implanted electronic devices that may be adversely affected by FES
• Unhealed bone fractures or musculoskeletal injuries in the extremities
• Severe contractures, extremely limited joint range of motion, or amputations that preclude cycling
• Extreme osteoporosis, osteoarthritis, or osteogenesis imperfecta
• Any other conditions that make exercise unsafe

What Are the Benefits of FES Cycling?

Engaging in FES cycling provides many benefits to the individual by: 

• Strengthening the muscles. 
• Improving cardiovascular health. 
• Maintaining or improving joint range of motion.
• Increasing muscle mass.
• Improving fitness.
• Increasing blood circulation. 
• Reducing muscle spasticity. 

FES cycling provides the benefits of therapeutic exercise to people living with paralysis. In addition to its well-known effect of endorphin release, therapeutic exercise also helps combat depression and the secondary conditions associated with immobility. Further, it is believed the nervous system begins to learn to rewire its connections through regular FES exercise, though further research is needed to confirm the effect. 

How Do I Participate in FES Rehabilitation?

FES cycles can be used in clinical facilities or purchased directly for home use. The MyoCycle is an FES cycle designed for safety, efficacy, affordability, and usability in both clinical and home environments.

Insurance

MYOLYN has a team of insurance personnel who work with your insurance company and file all necessary paperwork to either obtain prior authorization or direct reimbursement for your MyoCycle. Further, MYOLYN offers free case evaluations to help you determine your coverage eligibility.  

Grants

Organizations that provide grant funding for medical expenses include the following.

• Disabled Children’s Relief Fund (DCRF)
• High Fives Foundation Empowerment Fund
• Triumph Foundation*
• Cindy Donald Dreams of Recovery Foundation 
• Road 2 Recovery Foundation
• Bryon Riesch Paralysis Foundation**
• Challenged Athletes Foundation
• The Ryan Shazier Fund for Spinal Rehabilitation
• The Multiple Sclerosis Foundation

*Priority is given to residents of Southern California 

**Priority is given to residents of Wisconsin

Fundraising 

Several fundraising organizations allow individuals to obtain donor financial assistance for medical costs, which include the MyoCycle. These include:

• Help Hope Live Medical Fundraising
• GoFundMe Medical Fundraising

Financing

• Assistive Technology Loan Programs are offered on the national or state level.
  • On the national level: Digital Credit Union Access Loan and LoanNow Personal Loan for People With Disability 

For a comprehenisve list of funding resources for people experiencing paralysis visit our funding page! Here we outline dozens of grant, financing, and fundraising opportunities to help people experience the relief that comes from FES Cycling.

Does Clinical Research Support FES Cycling?

Decades of relevant research have shown that FES exercise of about 30 minutes a day, 3 days a week, is monumentally beneficial for those with little or no voluntary leg movement. It was found useful for the following benefits: 

One study found that FES exercise:  

• Prevents atrophy 
• Builds muscle and endurance 
• Increases strength 
• Recovers function 
• Increase and maintain range of motion, cycling power 
• Improve the quality of life
• Relax muscle spasms

Another study found that FES exercise allows for regaining sensation while improving self-image. Another found that it improves cardiorespiratory fitness and blood circulation. Moreover, it has been found to prevent bone density loss while also improving insulin sensitivity and glucose tolerance. 

Are There Any Side Effects of FES Cycling?

Electrical stimulation can sometimes cause a “pins and needles” feeling, but proper use of the electrodes and control of the stimulation intensity can reduce this occurrence. Similarly, your skin could become sensitive or slightly irritated at the electrode application site; the use of hypoallergenic electrodes can help with this issue. 

Is FES Cycling Only Available in Rehabilitation Centers?

Thankfully, no. The MyoCycle is available for both clinic and home use, making it easier than ever to maintain a consistent FES cycling routine no matter where you are – in a rehab facility or your residence. Its user-friendly, intuitive controls provide consistently effective, beneficial exercise for cyclists. Even better, the MyoCycle saves workout data so it can be shared with your comprehensive rehabilitation team to track your progress and adjust as needed.  

MYOLYN Brings Therapeutic Exercise Home for People Living with Paralysis

Living with paralysis, you may be overwhelmed, thinking you will be unable to exercise, or believing you have limited options. The team at MYOLYN is here to help, no matter where you are in your journey. Our MyoCycle enables the continuation of physical activity while also benefiting your entire body and its systems. Contact us today for more information and get back to moving!