Motion rehab physiotherapist and patientMotion rehab physiotherapist and patient
FES Cycling

FES Cycling with Transcutaneous Spinal Stimulation (tSCS)

At MOTIONrehab, we are committed to bringing the latest evidence-based rehabilitation technologies to people living with neurological conditions. Through our collaboration with THERA-Trainer and Anatomical Concepts, we are proud to offer one of the UK’s most advanced Functional Electrical Stimulation (FES) cycling services, incorporating the innovative Stim2Go® system and transcutaneous spinal cord stimulation (tSCS).

Unlike traditional FES cycling systems, our service combines advanced neuromodulation with expert neurological physiotherapy, allowing rehabilitation to continue beyond the bike and into meaningful functional activities.

What is FES Cycling?

Functional Electrical Stimulation (FES) cycling uses carefully timed electrical impulses to activate weakened or paralysed muscles while you pedal a stationary exercise bike. The stimulation causes muscles to contract in the correct sequence, enabling active cycling even when voluntary movement is limited.

Research has demonstrated that regular FES cycling can improve:

  • Cardiovascular fitness
  • Muscle strength and muscle bulk
  • Circulation
  • Bone health
  • Joint mobility
  • Exercise tolerance
  • Overall physical wellbeing

For many people living with neurological conditions, FES cycling provides an opportunity to achieve levels of exercise that would otherwise be impossible through voluntary movement alone. Consistent participation over months and years is associated with the greatest health benefits. (FES Cycling)

The evidence base for FES cycling is well established, with systematic reviews supporting benefits for fitness, muscle health, cardiovascular function and quality of life in people with neurological conditions.

Lower Limb FES Cycling

  • Muscle conditioning
  • Cardiovascular
  • Endurance
  • Circulation
  • Lower limb activation

Upper Limb FES Cycling

  • Improve shoulder stability
  • Increase arm strength
  • Enhance cardiovascular fitness
  • Increase upper limb activity
  • Complement intensive upper limb rehabilitation

FES Cycling Alone

FES cycling delivers electrical stimulation directly to peripheral nerves supplying in either the arms or legs. The stimulation is timed with the pedalling or hand -crank to generate movement.

  • Improved cardiovascular fitness
  • Increased muscle mass and strength
  • Reduced muscle atrophy
  • Improved circulation
  • Increased joint range of movement
  • Improved metabolic health
  • Maintenance of bone density through repetitive loading
  • Reduced secondary complications associated with immobility

FES Cycling with tSCS

Traditional FES cycling strengthens muscles and improves fitness by electrically activating weakened muscles during cycling. By adding transcutaneous spinal cord stimulation (tSCS), we aim to optimise the spinal networks that control movement, potentially enhancing motor learning, reducing spasticity and improving the carry-over of training into everyday activities. This combination represents an exciting advance in neurological rehabilitation by targeting both the muscles and the nervous system simultaneously.

While FES cycling activates muscles directly to produce cycling movements, tSCS aims to increase the excitability of the spinal networks that coordinate movement. The two therapies work together but through different mechanisms.

  • Prime the nervous system – The spinal cord becomes more responsive to incoming sensory information
  • Enhance motor learning -better recruitment of voluntary muscle activity & improved coordination
  • Reduce spasticity
  • Promote greater sensory feedback

Traditional FES cycling primarily trains the muscles. tSCS aims to optimise the nervous system so that those muscles are used more effectively. Instead of simply exercising muscles, tSCS is attempting to improve the nervous system’s capacity to produce movement.

Potential Clinical Advantages of Combining tSCS With FES Cycling

FES Cycling AloneFES Cycling + tSCS
Direct muscle activationMuscle activation plus spinal neuromodulation
Improves cardiovascular fitnessImproves cardiovascular fitness
Strengthens musclesStrengthens muscles
Maintains muscle bulkMaintains muscle bulk
Improves circulationImproves circulation
Provides repetitive movement practiceMay enhance motor learning during movement practice
Limited effect on spinal network excitabilityIncreases spinal network excitability
Exercise-focused interventionExercise combined with nervous system priming
Benefits often remain activity-specificMay facilitate carry-over into standing, walking and functional rehabilitation

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Who Can Benefit From FES Cycling?

  • FES cycling may be suitable for people living with:
  • Spinal Cord Injury (complete and incomplete)
  • Stroke
  • Multiple Sclerosis
  • Parkinson’s disease
  • Cerebral Palsy
  • Traumatic Brain Injury
  • Acquired Brain Injury
  • Other neurological conditions causing muscle weakness or paralysis

Suitability depends upon an individual assessment, including the integrity of the nerve pathways to the muscles being stimulated. Our specialist team will determine whether FES cycling is appropriate for your specific condition and goals. (FES Cycling)

What Does a MOTIONrehab Fes Cycling Programme Look Like?

Every programme begins with a comprehensive neurological assessment.

We assess:

  • Your diagnosis
  • Muscle activity
  • Movement ability
  • Spasticity
  • Functional goals
  • Skin integrity
  • Suitability for FES and tSCS

Your physiotherapist develops an individual programme including:

  • Electrode placement
  • Stimulation parameters
  • Cycling prescription
  • Functional rehabilitation goals
  • Home exercise advice where appropriate

As you improve, your programme progresses to include:

  • Longer cycling sessions
  • Increased exercise intensity
  • Functional strengthening
  • Standing practice
  • Walking practice
  • Upper limb rehabilitation
  • Neuromodulation with tSCS where appropriate

Regular reviews ensure:

  • Stimulation remains optimal
  • Goals continue to progress
  • Treatment evolves with your recovery
  • Equipment settings are updated as required

Discover Whether Fes Cycling Is Right for You

Every neurological condition is different, which is why every FES cycling programme begins with a detailed assessment by one of our specialist neurological physiotherapists.

Whether your goals are improving fitness, maintaining muscle health, reducing the effects of long-term neurological conditions, or exploring advanced technologies such as transcutaneous spinal cord stimulation, our team can help you understand what is achievable and develop a programme tailored to your individual needs.

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Client Stories

HOW MOTIONREHAB HAVE HELPED INDIVIDUALS TO REACH THEIR FULL POTENTIAL

UK’s first Intensive Robotic Neurological Rehabilitation Centre

In April 2018, MOTIONrehab launched the UK’s first Intensive Robotic Neurological Rehabilitation Centre. The centre in Leeds went on to be recognised by the Financial Times, Google and leading European policy makers as one of the Top 100 companies.

Following the success of MOTIONrehab’s Intensive Robotic Neurological Rehabilitation Centre in Leeds and after seeing such positive outcomes for its clients MOTIONrehab launched a second Intensive Robotic Neurological Rehabilitation Centre in Hull during December 2020 and a third in March 2024. MOTIONrehab’s Intensive Neurological Rehabilitation Centres accepts national and international referrals and are International Reference Centres for treatment, teaching and research.

CLIENT TESTIMONIALS

Our Results Speak For Themselves

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