Exercise is an important and powerful tool in rehabilitation and vital for a healthy lifestyle. Exercising on cool equipment in a motivational atmosphere makes it even more fun.
People with a traumatic spinal cord injury may benefit from using a state-of-the art FES cycle. FES stands for Functional Electrical Stimulation, a technique that uses pulses of electrical current to stimulate peripheral nerves, evoking muscle contractions and patterned muscle activity. It enables muscles to perform activities even though they’re weak or paralyzed by neuromuscular disease or injury.
FES cycling has been shown to be effective in:
• Reducing muscle atrophy
• Increasing local blood flow
• Maintaining or increasing range of motion
• Reducing spasms/spasticity
• Re-educating muscles
Thanks to a generous grant from the Craig H. Neilsen Foundation, the FES cycling program is offered through a collaboration between Mary Free Bed Rehabilitation Hospital and the Mary Free Bed YMCA, a universally designed fitness facility for people of all abilities. It’s the only program of its kind in Michigan and one of a handful offered nationwide.
If you’re interested, these are the requirements:
• Diagnosis of traumatic spinal cord injury
• Medical clearance and signed physician referral
• Evaluation for appropriateness established by a specially trained physical therapist at Mary Free Bed Rehabilitation Hospital
• YMCA membership (financial assistance program available)
Call the Mary Free Bed YMCA Wellness Desk at 616.885.5931.
What’s an FES cycle?
It’s a compact, portable device that allows you to cycle right from your wheelchair. Your feet are placed in footrests, and adjustable calf supports secure the legs. Restraints hold the wheelchair securely in position. Electrodes are placed on key muscle groups (quadriceps, hamstrings, gluteals, gastric, anterior tibialis, abdominals and back muscle groups) and attached to leads.
What are the benefits?
FES has been shown to reduce muscle atrophy, increase local blood flow, maintain or increase range of motion, reduce spasticity and re-educate muscles. Regular users speak positively regarding its impact on fitness due to exercise intensity.
Are there any risks?
People with higher-level spinal cord injuries may experience autonomic dysreflexia when they use the FES cycle. Some people may notice increased leg spasms as their muscles get used to cycling. If not set up on the cycle properly, there’s a risk of developing blisters, skin irritation, pressure injuries, strained joints, etc.
How do I know if FES cycling is appropriate for me?
Before we can schedule an evaluation, your physician must provide medical clearance and refer you to a Mary Free Bed physical therapist specifically trained in FES.
Ideal candidates are:
• People with upper motor neuron injuries, such as traumatic spinal cord injury, who respond positively to electrical stimulation.
• Other appropriate medical diagnoses include brain injury, cerebral palsy, multiple sclerosis, spina bifida and stroke.
How does the physical therapy referral and evaluation process work?
Your physician must complete our medical clearance and referral form, and fax it to Mary Free Bed Outpatient Scheduling at 616.840.9642 along with a Physical Therapy Evaluate and Treat for Upgrading Exercise Program including FES prescription. Mary Free Bed personnel will obtain insurance authorization and payment information, then call you to schedule an initial physical therapy evaluation.
During the hour-long appointment at Mary Free Bed Rehabilitation Hospital, you’ll be evaluated by a physical therapist specially trained in FES on the same type of cycle located at the Mary Free Bed YMCA. Please wear or bring shorts and gym shoes.
The results will be shared with you immediately following the evaluation.
How will I be trained to use the FES cycle at the Mary Free Bed YMCA?
Your physical therapist will schedule additional sessions using the FES cycle at Mary Free Bed Rehabilitation Hospital. You and your caregiver will work with the physical therapist to develop an individualized program and teach you how to use the FES cycle independently.
You’ll both learn and demonstrate proper set up, electrode placement, basic operation of cycle components and how to make simple adjustments to your program. It may take up to five one-hour sessions before you’re ready to transition to the Mary Free Bed YMCA. You’ll be scheduled for a reassessment visit with the physical therapist later to make sure your cycling program is going smoothly.
Do I need to become a member of the Mary Free Bed YMCA to use the FES cycle?
After your physical therapist determines you and your caregiver can transition to using the FES cycle at the Mary Free Bed YMCA, you’ll need to become a member if you aren’t already. For membership information:
• Call 616.885.5931.
• Visit grymca.org.
• Stop by the Mary Free Bed YMCA, 5500 Burton St. SE in Grand Rapids.
How do I get started using the FES cycle at the Mary Free Bed YMCA?
To schedule your first FES cycle session, visit or call the Mary Free Bed YMCA’s Wellness Desk at 616.885.5931. When you arrive for your session, a YMCA FES trainer will help you get started. Bring a copy of your FES Competency along with your electrodes.
Schedule subsequent sessions with the Wellness Desk to reserve the FES Cycle. Sessions are scheduled in 1.5-hour blocks to allow time between users for set up, cycling and electrode detachment.
What if I need additional assistance?
The Mary Free Bed YMCA’s FES trainers can assist you with minor adjustments, such as helping to connect FES cycle leads to electrodes and adjusting resistance. If you need additional help, they can connect you with the Clinical Support Team at Restorative Therapies, Inc., the bike’s manufacturer.
By providing your FES Cycle ID and PIN numbers, the RTI team can access your program and assist with questions. The team may recommend additional assistance from your Mary Free Bed FES physical therapist, and direct you to schedule a follow-up appointment at 616.840.8825.
What does it cost to use the FES cycle?
Costs, depending on your insurance coverage, include medical or therapy visit co-pays, YMCA membership (ask about the financial assistance program) and replacement electrodes. Since insurance coverage varies, ask your provider for out-of-pocket costs prior to your appointments, including if your insurance will cover the cost of replacement electrodes.
When your Mary Free Bed scheduler contacts you for your initial evaluation, he or she can provide information regarding physical therapy appointment insurance coverage and co-pays for any sessions at Mary Free Bed.
How do I purchase replacement electrodes?
You’ll receive the first set of electrodes from your Mary Free Bed physical therapist. They are expected to last about 10 sessions. You can extend the life of your electrodes by using them on dry, clean, unbroken skin (don’t apply skin lotion before you plan to work out). Electrodes will lose their “stickiness” quicker if used on hairy surfaces. Discard and replace electrodes if they are damaged, show signs of wear or no longer adhere to your skin.
REQUIREMENT: You must use PALS Platinum or ValuTrode Foam electrodes. Others will damage the FES cycle. They are available for purchase online through RTI, Health Products for You or Axelgaard. Order the size recommended by your physical therapist.