Comparison of energy costs of leg-cycling wheelchairs with or without functional electrical stimulation and manual wheelchairs for patients after stroke

Objective: To determine whether, for patients after stroke, propelling a functional electrical stimulation (FES)-assisted leg-cycling wheelchair requires less energy than propelling a manual wheelchair, and whether leg propulsion with FES has lower energy costs than without FES. Design: Within-subject comparison. Subjects: A total of 16 patients after stroke were recruited from the university hospital. Methods: Subjects propelled 2 leg-cycling wheelchairs (a FES-leg-cycling wheelchair and a leg-cycling wheelchair) and a manual wheelchair for 200 m as quickly as possible. Cardiopulmonary responses (heart rate, oxygen consumption, carbon dioxide production, minute ventilation, and respiratory exchange ratio) and energy costs (physiological cost index and oxygen cost) data for each wheelchair-type were compared for each subject. Results: The cardiopulmonary responses were significantly higher, and energy costs significantly lower for propelling the FES-leg-cycling wheelchair and leg-cycling wheelchair compared with the manual wheelchair. No significant difference was found between the FES-leg-cycling wheelchair and the leg-cycling wheelchair. Conclusion: Propulsion of a leg-cycling wheelchair with or without FES yielded significantly higher cardiopulmonary responses and required less energy than propulsion of a manual wheelchair. The energy costs of cycling with FES was comparable to the energy costs of cycling without FES.