Superman's bicycle helps paraplegic patients keep fit and healthy
8 June 2008
A new type of exercise equipment can help prevent serious lifestyle
illnesses in paraplegic patients. The Ergys 2, which was partly
developed at the Norwegian University of Science and Technology (NTNU)
in Trondheim, was first designed for the American actor Christopher
Christopher Reeve, who played Superman in films, became a
quadrapelgic after a riding accident and financed the development of the
rehab equipment, in the hopes of improving his own health. But that
didn’t quite happen, and the actor died of heart failure when he was
just 52 years old. Nevertheless, his efforts gave the world’s spinal
injury patients a useful piece of rehabilitation equipment.
Patients who are unable to walk after a spinal injury have a poorer
quality of life and a shortened lifespan than their non-paralysed
counterparts. Sitting passively in a chair makes people susceptible to
weight and digestion problems, lower bone density, diabetes, and last
but not least, heart and circulation problems.
“It’s the circulation problems that are the most difficult for them,
and it’s circulation problems that kill them”, says Jan Hoff, a
professor of medicine at NTNU. But it doesn’t have to be that way. A new
type of exercise equipment, combined with a new training plan, makes it
possible for spinal patients to exercise themselves back to health — at
least as far as the heart is concerned.
In an exercise study completed last year, patients who were paralysed
from the chest or waist down experienced an average increase in their
oxygen uptake by 25% and in their heart pumping volume by fully 37%
after just eight weeks of training.
Never before has so much improvement or such impressive results been
documented in this patient group.
Ready for interval training on the Ergys 2: Terje Roel is
paralysed as a result of a spinal injury. Researcher Berit Brurok is
readying Terje for a demonstration of the arm and leg cycle. Photo
credit: Vegard Eggen/Gemini J.
Not just a stationary bicycle
The Ergys 2 is a stationary training bicycle, where the patient’s
legs and feet are strapped to a leg holder and pedals. Electrodes are
then fastened to the patient’s thigh and seat muscles, and electrical
impulses trigger the muscles to contract and relax.
The impulses are computer controlled to guarantee the best possible
effect. Even though it may seem like artificial training, it is real
enough as it’s the patient’s own muscles that are working. And it is
movement that demands energy: the blood flow increases, and the pulse
goes up. The exercise has an effect on muscle mass, muscle strength,
oxygen uptake and the heart’s pumping volume.
Hard workouts, few repetitions
But it’s not enough to focus on the legs and buttocks, if this kind
of training is going to make a real difference. The more muscle groups
that are involved, the greater the blood flow, and the greater the
benefits for the heart.
NTNU researchers supplemented the Ergsys 2 with an arm cycle,
intended for patients who can use their arms without help. The patients
who participated in the training study were also able to simultaneously
exercise their shoulders, arms, rump and legs, in a high-intensity
interval 4 x 4 pattern. That translates to four minutes of hard exercise
followed by three to four minutes of easier training, with the entire
procedure repeated four times per session, three days a week.
NTNU’s Professor Jan Hoff developed this interval approach several
years ago, along with his colleague Jan Helgerud. He uses this interval
technique for most types of physical training.
“Hard workouts, few repetitions. There is no other training approach
that gives better results in improving oxygen uptake or muscle strength
than that”, he says.
A preventative approach
Never before has research documented such a significant effect on the
heart and circulation in patients with spinal injuries, as the study has
shown. There has been relatively little research overall on spinal
patients and exercise, in terms of what kinds and how much exercise
actually give beneficial results.
The patients in this study were so out of shape when they started
that they were unlikely to reach a normal level. But Hoff doesn’t think
it’s an impossible goal. “We really don’t know, but there’s no reason to
believe that the improvements will stop where they are now”, he says.
Hoff doesn’t want to speculate on the implications of his research on
the treatment of Norwegian patients paralysed from spinal injuries.
“We’re researchers, not therapists” he says. “But it’s clear that
what we’re doing has consequences, both for Norway and for the world.
And that gives us a great opportunity to prevent lifestyle related
Under Hoff’s guidance, Berit Brurok conducted the study for her
master’s thesis in exercise physiology. Brurok is continuing her work in
this area as a part of her PhD research, in cooperation with Dr Tom
Tørhaug at St Olavs Hospital in Trondheim.
Because the Ergys 2 is expensive, and also requires assistance to
use, the researchers are looking to see if the results from the study
can be transferred to other activities such as in a wheelchair or
If they succeed, it could mean a better quality of life and a longer
life for many people. In Norway alone there are 5000 spinal injury
patients, while in the USA that number may be closer to 500,000.