For FES-Cycling there are mixed results for bone outcomes. Three studies found an increase in BMD (Mohr et al.1997; Chen et al. 2005; Frotzler et al. 2008) at the proximal tibia or distal femur while there was no significant within-participant BMD change at the hip in 3 pre-post studies (Pacy et al. 1988; Leeds et al.1990; and BeDell et al.1996) The FES-cycling studies which reported a positive effect on bone parameters used protocols that were at least 3 sessions/week for 6 months in duration, and increased bone parameters over areas directly affected by stimulated muscles (e.g. quads, distal femur and proximal tibia). Although one study showed that FES-cycling intervention needed to be maintained or bone gains were lost (Chen et al. 2005), Frotzler and colleagues found BMD and BMC were preserved at the distal sites for some participants at 12 months. FES shows promise as an effective treatment around the knee; however the limited availability of cycle ergometry for home or longitudinal use may limit its generalizability if the therapy cannot be sustained outside a clinical trial scenario.
- There is level 4 evidence (Mohr et al.1997; Chen et al. 2005; Frotzler et al. 2008) that FES cycle ergometry increased regional lower extremity BMD over areas stimulated.
FES cycle ergometry may increase lower extremity BMD over areas stimulated.