FES Assisted Cycling in Children With CP

Functional Electrical Stimulation Assisted Cycling to Improve Fitness and Strength in Children With Cerebral Palsy

This project proposes to assess if Functional Electrical Stimulation (FES) assisted cycling can improve the cycling ability, muscle strength, cardiovascular health, quality of life, self perception and functional mobility of adolescents with CP better than a volitional cycling program or a non-intervention control group.

Aim 1: To compare the effects of 8-weeks of FES-assisted cycling training on improving cardiorespiratory fitness, walking function, self-motivated exercise/recreation, self-perception and functional mobility and quality of life of adolescents with spastic CP with marginal walking ability (Gross Motor Function Classification System Levels II - IV) vs. 8-weeks of volitional cycling training and a non-intervention control group.

Aim 2: To compare the effects of 8-weeks FES-assisted cycling training on changes in cycling ability of adolescents with spastic CP with marginal walking ability vs. 8-weeks of volitional cycling training and a nonintervention control group.

Aim 3: To elucidate the mechanisms for potential improvements in cycling ability after 8-weeks of FES-assisted or volitional cycling training of adolescents with spastic CP and marginal walking ability.

Inclusion Criteria:

• Spastic CP (di-, tetra-, or triplegic)
• Level II, III or IV GMFCS classification
• Sufficient covering of the femoral head in the acetabulum (migration % < 40)
• Adequate range of motion of the hips, knees and ankles to allow pedaling
• Visual, perceptual, cognitive, and communication skills to follow multiple step commands for attending to exercise and data collection
• Seizure-free or well controlled seizures

Exclusion Criteria:

• Athetoid, ataxic, or hemiplegic CP
• Significant scoliosis (primary curve > 40°)
• Spinal fusions extending into the pelvis
• Severe tactile hypersensitivity
• Joint instability or dislocation in LE
• LE surgery or fractures in the past year
• Botox injections to LE in the past 6 months
• Severe spasticity in LE (Mod Ashworth 4)
• LE joint pain during cycling
• Hx of pulmonary disease limiting exercise tolerance or Hx of cardiac disease
• Severely limited ROM / contractures that prevent the subject from being able to be safely positioned on the cycle
• Pregnancy