Institution of Mechanical Engineers IMechE

FES Rowing after Spinal Cord Injury

23 June 2010

The positive health benefits associated with regular physical exercise, in terms of preventing heart disease, diabetes 2, some cancers and dementia are being established. In the general population, physical exercise with an intensity of at least 6 METs and a volume of at least 1200-2200 kcal/week is recommended to significantly lower the relative risk of coronary heart disease. However, many people with paralysis following spinal cord injury can have difficulty in achieving these levels using only their preserved upper limb musculature. Even though some can achieve moderately high peak oxygen consumption, maintaining sufficient aerobic power with a small muscle mass is difficult and may be limited by fatigue of the highly stressed arm musculature despite adequate systemic responses. Furthermore, over 50% of chronic wheelchair users develop painful and often debilitating overuse syndromes of the upper limbs, therefore, any proposed physical exercise should not exacerbate this condition.

The solution may be to increase the metabolically active muscle mass by electrically stimulating the paralyzed lower limbs simultaneously with voluntary upper limb exercise. This so called “hybrid exercise” is being explored using an adapted indoor rowing ergometer. Quadriplegics and paraplegics have successfully used the equipment and the above recommended levels for intensity and volume have been achieved by paraplegic rowers. The pulling actions of rowing involve different shoulder/arm musculature than those used in wheelchair propulsion and may help reduce pain and prevent overuse injury.

FES assisted rowing may also open up new sport and recreation opportunities for individuals with SCI. Some FES rowers have successfully competed alongside able-bodied rowers over 2,000m in major international indoor rowing competitions. Further work is now underway to develop FES rowing on water.

The lecture will illustrate the biomechanical development of the FES technology and adaptation of ergometers and sculls.

Clips:

Smith and Nephew Lecture 2010

: Brian Andrews Professor of Biomedical Engineering Brunel University

Brian was trained in Cybernetics, Mathematics, Control Systems and Bioengineering at the Universities of Reading, Sheffield and Strathclyde. He has held academic and clinical positions in the UK, USA and in Canada where he was awarded “Heritage Scientist” by the Alberta Heritage Foundation for Medical Research. He has a long standing interest in human movement, beginning with his PhD work at Strathclyde that led to the development of the Vicon motion analysis system. Subsequent contributions include the development of “hybrid orthoses” that combine orthotics with FES and real-time machine learning control to restore ambulation after spinal cord injury. He is now involved in the development of FES technology to provide high intensity physical exercise after spinal cord injury. He is presently professor of Biomedical Engineering at the Brunel Institute for Bioengineering at Brunel University and a visiting professor in the Nuffield Department of Surgery at Oxford University where he also conducts research into restoring urinary continence following SCI.

Duration: 1:08