Abstract
Functional electrical stimulation (FES) bicycle training is a physical rehabilitation technique used to promote muscle recovery and/or cardiorespiratory health in persons with lower extremity impairment due to neurologic injury. FES cycling may also increase bone mineral density (BMD) in such populations, although no consensus exists that supports FES-induced skeletal improvement, in-part due to the extended 9-12 + month duration necessary to detect BMD gain in humans and the multitude of FES parameter permutations that require optimization to improve bone strength and/or reduce fracture risk, which may differ from those needed to improve muscle or cardiovascular fitness. Rodent models have been used in FES studies because musculoskeletal changes are phenotypically like humans but occur over an accelerated time course that permits more rapid identification of potentially efficacious FES parameters. To gain accelerated understanding of FES-cycling in humans, we performed a kinematic analysis of the rat hindlimb with a fixed hip location and variable foot location as the pedal of the bicycle rotated about the crank. Based on this analysis, an FES pattern was developed for the femoral and sciatic nerves to produce forward (clockwise) or reverse (counterclockwise) motion of the crank. These modeled FES patterns were validated in nine experiments that used 743 unique stimulation trials conducted in anesthetized male and female rodents. Such insights represent initial steps to facilitate closed-loop FES control of cycling in rats, which will help to refine rehabilitation strategies to promote bone and muscle recovery in rodent models and ultimately people.