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There is a lot of literature on bikes with Functional Electrical Stimulation for people with paraplegia. This is because with paraplegia an extreme inactivity occurs, and this can be compensated with FES cycling. Caused by the big difference, it is easy for researchers to get short-term results.

For visitors of the BerkelBike website a subscription to Refshare has been taken. Through this program, you can dig extensively into the collected literature. Thus it is possible in the menu through VIEW and FOLDER to look at several folders with references, like the map FES CYCLING and to crawl through separately using the search options. Behind every reference stands VIEW, when you click on it, you get the summary of the article. For a movie about the possibilities and procedure of Refshare; click on HELP and subsequently on TUTORIAL. Refshare literatuur database




FES literatuur dwarslaesie



FES arteriele doorbloeding





Researchers of the BerkelBike; D. Thijssen, P. Heesterbeek en B. van Ginneken gave presentations at the international conference Restoration of (wheeled) mobility in SCI rehabilitation, that was held in Amsterdam in April 2004, about the Clinical Trial, that was carried out with the BerkelBike.

Drs. D. Thijssen showed the increase of the blood flow in the stimulated area.

Drs. P. Heesterbeek proved the training effects on the general health, expressed in Oxygen uptake and breathing volume.

Msc. B. van Ginneken has demonstrated the added value of hybrid training (handbiking in combination with FES encouraged cycling) over handbiking alone. Previously, the highest VO2 max was achieved with handbiking, when it comes to sports for paraplegics.


Some published abstracts: 


  • Gerrits HL et al: The effect of cycling training with a spinal cord injury. Geneeskunde en Sport:33,6:7-15:2000





    Conclusion: 6 weeks electrically stimulated training leads to increase in cycling achievement and an increase in the contraction speed and endurance of the m. quadriceps. At rest also a greater blood flow in the femoral artery was found, which indicates an increase in capacity of the peripheral vascular bed of the lower extremities.


  • Roelofs: Pressure ulcers, a literature review in pathophysiological factors. Department of Physiology, University of Nijmegen: May 1999





    Conclusion: FES stimulated cycling has a major preventive effect on ulcers, through an improved blood flow, increased muscular tissue of the bottom and an improved immune system.


  • Janssen T. W. J., Glaser R. M., Shuster D. B.: Clinical Efficacy of Electrical Stimulation Exercise Training: Effects on Health, Fitness, and Function. Topics in Spinal Cord Injury Rehabilitation (Stephen Figoni, issue editor; David Apple, editor): Winter 1998, An Aspen Publication.





    Conclusion: the collected research results suggests strongly that active training using FES, may have several therapeutic effects on people with a spinal cord injury.


  • Mohr T., Andersen J., Biering-Sorensen F., Henrik G., Bangsbo J., Wagner A., Kjaer M.: Long term adaptation to electrically induced cycle training in severe spinal cord injured individuals. Spinal Cord : Vol. 35: 1-16, 1997.





    Conclusion: electrically stimulated cycle training during a year can reverse several changes as a result of inactivity after a SCI. Among other things, a 12% growth of the stimulated muscle tissue and a 6-fold increase in work performance was found, as well as an increase in maximum oxygen of 19%.


  • Nash M. S., Montalvo B. M., Applegate B.: Lower extremity blood flow and responses to occlusion ischemia differ in exercise-trained and sedentary tetraplegic persons. Archives of Physical Medicine and Rehabilitation: Vol. 77: 1260-1265, 1996.





    Conclusion: tetraplegics, trained with electrically stimulated cycling, have a larger circulation in the lower extremities and a larger hyperemic response to occlusion than not trained tetraplegics.



  • Hooker S. P., Scremin E., Mutton D. L., Kunkel C. F., Cagle G: Peak and submaximal physiologic responses following electrical stimulation leg cycle ergometer training. Journal of Rehabilitation Research and Development: Vol. 32, No. 4: 361-366, 1995.





    Conclusion: twice a week electrically stimulated cycling results in significant increases in exercise tolerance and cardiovascular capacity.


  • Twist, D. J., Culpepper-Morgan J. A., Ragnarsson K. T., Petrillo C. R., Kreck M. J. Neuroendocrine changes during functional electrical stimulation. American Journal of Physical Medicine and Rehabilitation: 71: 156-163, 1992.





    Conclusion: 30 weeks electrically stimulated training leads to significant increase of beta-endorphin regulated immune responsiveness, improved cortisol regulation and improved scores on a depression index.


  • Kristjan T. Ragnarsson, Susan Pollack Feldman, Donna Twist. Lower limb endurance exercise after spinal cord injury: implications for health and functional ambulation. J Neuro Rehab 1991;5:37-48.





    Conclusion: when the lower motor neuron system is intact, paraplegics and quadriplegics can provide significant effort by the use of computerized functional electrical stimulation. Many effects as a result of physical inactivity after a spinal cord injury can be reversed by FES intervention.


  • Steven P. Hooker, Stephen F. Figoni, Roger M. Glaser, Mary M. Rodgers, Bertram N. Ezenwa, Pouran D. Faghri. Physiologic responses to prolonged electrically stimulated leg-cycle exercise in the spinal cord injured. Archives of Physical Medicine and Rehabilitation: Vol. 71: 863-869, 1990.





    Conclusion: despite the presence of sympathetic constraints, 30-minute electric stimulated cycling in a controlled environment does not lead to inefficient physiological reactions of individuals with a spinal cord injury.


  • Sipski M. L., Delisa J. A., Schweer S. Functional electrical stimulation bicycle ergometry: patient perceptions. American Journal of Physical Medicine and Rehabilitation: 68: 147-149, 1989.





    Conclusion: a majority of the subjects with a spinal cord injury indicated to have an improved self-esteem as a result of training.


For much more literature including original summaries about FES cycling, consult our literature database.