Robin Gibbons sustained a complete spinal cord injury (SCI) at chest level following a road traffic accident in 2001. During his rehabilitation following hospitalisation, Robin realised that 2-limb exercise modalities, even at relatively high intensities, were not sufficient to protect against cardiovascular disease. In 2003, Robin was introduced to a novel technology called Functional Electrical Stimulation (FES). During a demonstration at the London Regatta Centre, Robin witnessed another person with a similar SCI rowing on an adapted Concept 2 indoor ergometer using both arms and legs.

This technology uses electrically stimulated lower limbs concurrent with voluntary arm exercise, in this instance, to produce a rowing action. This allows an individual with SCI to exercise a significantly greater muscle mass than would otherwise be possible, and by so doing, uniquely challenge the cardio-respiratory systems. Intrigued, Robin joined the FES-Rowing research Group lead by Professor Brian Andrews. Two years later found him conducting his own independent research in collaboration with the Group. This initially involved three pilot studies. The FES-rowing Group had first conducted studies with low level SCI known as paraplegia, since individuals with high level injuries, known as tetraplegia, could not operate the hand-controlled electrical stimulation system. Since individuals with tetraplegia represent the lower end of the activity spectrum, Robin was driven to develop the equipment sufficiently for people with tetraplegia to use.

In the first pilot study, Robin recruited 10 individuals with paraplegia and 5 with tetraplegia; all successfully learnt to row using the re-developed system for up to 30 minutes three times a week. This study also established the training protocols that have been used ever since. These same training protocols have also been adopted by international research groups that Robin has worked with in America and Canada.

The second pilot study compared the cardiorespiratory health and fitness of individuals trained in FES-rowing with those with SCI who had remained sedentary. A small non-injured group were used as controls. Whilst the numbers in each group were too small for statistical significance, the results never the less showed a trend towards the FES-rowing group having similar cardiorespiratory health and fitness to the non-injured group. The third pilot study is investigating lower limb bone health using biomechanical analysis techniques. This study is still being run.

The initial pilot studies, which represent over 3 years work, have shown very encouraging trends towards improved cardiorespiratory fitness and lower limb bone health that Robin is now hoping to statistically confirm through a longitudinal study with a new group of individuals with both paraplegia and tetraplegia. Robin's hypotheses are that carefully controlled FES-rowing training programmes will 1. Protect individuals with SCI against cardiovascular disease and 2. Reverse lower limb bone mineral density loss.

Robin first presented his cardiorespiratory pilot study findings at this year's Student BASES (British Association of Sport and Exercise Sciences) conference on 11th and 12th April held at the University of East London. Robin's poster entitled "FES-Rowing can affect cardiac structure and improve cardiorespiratory function in SCI: a pilot study" won first prize in the postgraduate poster category.

Although FES-rowing has shown the greatest cardiorespiratory response of any exercise modality in paraplegia and more recently tetraplegia, the FES-Rowing Group is continuing equipment development with multi-channel stimulation to enable recruitment of four major muscle groups in the lower body, and an automatic switch control for individuals with tetraplegia.

The image above is of Marrianne who has a C4 complete spinal cord injury & shows her FES-rowing training.