Person with multiple sclerosis using a FES bike in a modern living room.

FES Cycling: A New Path to Fitness for MS Patients with Limited Mobility

Kai Mendoza in Health & Wellness July 2025 • 5 min read.

"Discover how Functional Electrical Stimulation (FES) cycling can boost cardiorespiratory fitness and overall well-being for multiple sclerosis patients with severe mobility challenges."

For individuals with multiple sclerosis (MS), maintaining cardiorespiratory fitness (CRF) is vital for overall health, yet mobility limitations can present a significant challenge. Lower CRF in MS sufferers is linked to increased morbidity and mortality, Functional Electrical Stimulation (FES) cycling has emerged as a promising solution. This adaptive exercise modality uses electrical stimulation to activate muscles, enabling cycling even with severe mobility impairment.

Traditional exercise programs often exclude individuals with significant mobility challenges (EDSS ≥5.5), underscoring the need for alternative approaches. FES cycling bridges this gap, offering a means to enhance CRF and mitigate physiological deconditioning in a population often left behind.

This article will delve into a study evaluating the impact of FES cycling on individuals with MS and severe mobility impairment. It will explore how FES cycling compares to passive leg cycling in terms of cardiorespiratory demand, offering insights into its potential as an effective exercise modality.

Unlocking Fitness with FES Cycling: How it Works

Person with multiple sclerosis using a FES bike in a modern living room.

The study, involved participants with MS who required assistance for ambulation. They underwent a single session of voluntary cycling with FES and passive leg cycling. Researchers carefully monitored several key indicators: oxygen consumption (VO2), heart rate (HR), work rate (WR), and ratings of perceived exertion (RPE). These measurements provided a comprehensive understanding of the body's response to each type of cycling.

The results clearly demonstrated the benefits of FES cycling. The FES group showed a mean exercising VO2 of 8.7±1.8ml/kg/min, representing 63.5% of their peak VO2. Their mean heart rate reached 102±9.7 bpm, about 76.4% of their peak HR. The mean work rate was 27.0±9.2 W, 57.3% of their peak WR, and participants reported a median RPE of 13.5. Active cycling with FES proved significantly more intense than passive leg cycling, as evidenced by the higher VO2, HR, WR, and RPE values.

Increased Oxygen Consumption: FES cycling significantly raises VO2, indicating higher energy expenditure and cardiovascular engagement.
Elevated Heart Rate: The heart rate response during FES cycling suggests a workout intensity that can lead to improved cardiovascular health.
Greater Work Rate: Participants achieved a higher work rate with FES, highlighting its potential for building strength and endurance.
Higher Perceived Exertion: The increased RPE scores reflect the greater effort required during FES cycling, supporting its effectiveness as a workout.

Voluntary cycling with FES elicits an acute response that corresponds with moderate-to-vigorous intensity activity. Active cycling with FES can elicit a sufficient stimulus for improving CRF. The study highlights that FES cycling isn't just about movement; it's about achieving a level of exertion that can drive real fitness improvements.

The Future of Fitness for MS: Accessible, Effective, and Empowering

The study confirms that voluntary cycling with FES elicits a cardiorespiratory stimulus comparable to moderate-to-vigorous physical activity. This combination of voluntary leg cycling and supplementary neuromuscular stimulation can assist individuals with severe MS to achieve higher exercise training intensities. It's not just about physical fitness; it's about improving overall well-being and quality of life.

FES cycling holds significant promise as an accessible exercise modality for individuals with MS and severe disability, with other studies also demonstrating the potential benefits of FES cycling for individuals with spinal cord injuries. Its accessibility makes it possible for more MS sufferers to improve their fitness from the comfort of home.

While this study provides valuable insights, larger sample sizes and comparisons with other exercise modalities are needed to further validate these findings. Future research should also explore the long-term effects of FES cycling on CRF, muscle strength, and overall quality of life in individuals with MS.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1139/apnm-2017-0397, Alternate LINK

Title: Cardiorespiratory Demand Of Acute Voluntary Cycling With Functional Electrical Stimulation In Individuals With Multiple Sclerosis With Severe Mobility Impairment

Subject: Physiology (medical)

Journal: Applied Physiology, Nutrition, and Metabolism

Publisher: Canadian Science Publishing

Authors: Thomas Edwards, Robert W. Motl, Lara A. Pilutti

Published: 2018-01-01

Everything You Need To Know

What exactly is Functional Electrical Stimulation (FES) cycling?

Functional Electrical Stimulation (FES) cycling is a specialized exercise method designed to assist individuals with Multiple Sclerosis (MS) and significant mobility limitations. It utilizes electrical stimulation to activate muscles, thereby enabling cycling even when a person has severe mobility impairment. This approach allows these individuals to engage in physical activity and potentially enhance their overall health and quality of life, where traditional exercises programs aren't suitable.

Why is Functional Electrical Stimulation (FES) cycling important for people with Multiple Sclerosis (MS)?

The significance of Functional Electrical Stimulation (FES) cycling lies in its ability to improve the cardiorespiratory fitness (CRF) for individuals with Multiple Sclerosis (MS), particularly those with limited mobility. Lower CRF in MS patients is associated with increased morbidity and mortality. By enabling individuals to engage in exercise, FES cycling offers a means to enhance CRF, helping mitigate the physiological deconditioning often experienced by those with mobility issues. It fills the gap where traditional exercise programs fall short, offering a viable solution for fitness improvements.

What happens to the body during Functional Electrical Stimulation (FES) cycling?

During Functional Electrical Stimulation (FES) cycling, several physiological responses are observed. Specifically, increased oxygen consumption (VO2) indicates higher energy expenditure and cardiovascular engagement. Elevated heart rate (HR) suggests a workout intensity that can lead to improved cardiovascular health. A higher work rate (WR) indicates the potential for building strength and endurance. Increased perceived exertion (RPE) scores reflect the greater effort required, supporting its effectiveness as a workout. These measures demonstrate that active cycling with FES provides a sufficient stimulus for improving cardiorespiratory fitness, offering a valuable exercise modality.

How does Functional Electrical Stimulation (FES) cycling benefit those with Multiple Sclerosis (MS)?

Functional Electrical Stimulation (FES) cycling is important for people with Multiple Sclerosis (MS) because it allows them to engage in physical activity despite mobility challenges. The study shows that voluntary cycling with FES elicits a cardiorespiratory stimulus comparable to moderate-to-vigorous physical activity. This type of exercise helps maintain cardiorespiratory fitness (CRF), which is essential for the overall health and well-being of individuals with MS. The combination of voluntary leg cycling and supplementary neuromuscular stimulation can assist those with severe MS to achieve higher exercise training intensities.

What are the potential implications of using Functional Electrical Stimulation (FES) cycling?

Functional Electrical Stimulation (FES) cycling has implications beyond mere physical exercise. By improving cardiorespiratory fitness (CRF), it directly addresses the health risks associated with mobility limitations in Multiple Sclerosis (MS) patients. It is important for the overall well-being and quality of life. The use of FES cycling could potentially lower the risk of increased morbidity and mortality linked to lower CRF. The ability to engage in a moderate-to-vigorous workout can offer improvements in health, and can also empower individuals with MS by providing a means to participate in physical activity, improving their overall well-being and quality of life.