The FES Community Initiative Provides Choice for Edmontonians Living with Impairment

“It’s uplifting. You get a sense of pure joy,” says Detective Bryce Clarke about being able to see his legs working, even if he can’t feel them. Clarke has been using Functional Electrical Stimulation since 2002, after an accident in 2001 left him a quadriplegic. Because of a recent initiative to increase access to FES and physical activity options for individuals experiencing disability, Clarke now works out at the Saville Centre. Clarke's physical and emotional well-being combined with the personal freedom of being able to work out in a community fitness centre on his own schedule contribute a great deal to his ability to fulfill his duties as a full-time detective and live independently.  “I really appreciate the collaboration it took and the work of all of the individuals who made it possible.” 

Read more about Detective Bryce Clarke

The Steadward Centre (TSC) Functional Electrical Stimulation (FES) initiative began in 2011 in response to a two-sided gap in accessibility to FES in the Edmonton region. Since 1991 the TSC was the only option for long-term FES exercise participation in Edmonton and surrounding areas. The program supported approximately 30 participants per week. As a result, many people had to wait to access FES, and TSC FES participants had only one option for participation in physical activity, limiting their options to exercise with family or friends, or to choose an exercise setting and time that worked best for them. 

Addressing the Gap

Bridging the gap was like putting together pieces of a puzzle. Collaboration from a range of community partners was needed, including: 

  • a facility to host the initiative, specialized FES equipment and staff training on FES equipment; 
  • qualified volunteer physiotherapists and exercise physiologists to provide assessments, and to help train in adapted physical activity protocols; 
  • volunteer and peer mentorship coordination and training to help participants gain confidence and skills to complete their own workout sessions. 

“It was a real collaborative effort,” says TSC Associate Director, Karen Slater. “We are so pleased to see this project come to fruition. With the support and dedication of partners such as the Spinal Cord Injury Treatment Centre Society and the Saville Community Sports Centre, we have been able to respond to an overwhelming need identified by members of our community—we can now provide individuals with choice and greater access to FES exercise, be it at our Centre or in the community.” 

Slater also adds that TSCs' Community Transition team were outstanding. “This initiative would not have been the success it has been without the tremendous amount of hard work and forward thinking of our Transition team, Bobbi-Jo Atchison and Jessica Imppola.” Since 2008, TSC Community Transition team has provided training, coordination, facilitation and consulting to community members, facilities, and individuals experiencing disability to work out in community centres of their choice. 

This sentiment is echoed by SCITCS president, Louise Miller who feels that the Community Exercise Transition model is a tremendously worthwhile initiative. “Inclusivity is a word that is bandied about by many,” says Miller, “but it’s not so easy to achieve.”  For individuals experiencing disability, being able to exercise alongside family and friends is huge. “That’s what it's all about, isn’t it? —Getting out on your own." 

A special thank you also goes out to Research Physical Therapist Su Ling Chong and Dr. Trish Manns, Associate Professor, Faculty of Rehabilitation Medicine who thoroughly assessed all potential program participants to ensure that they were suitable for FES participation. 

Putting it all together

Robin Gibbons uses the FES rowerThe Saville Community Sports Centre stepped forward to work with TSC and to provide support for staff training, peer mentorship, student volunteer training, and a welcoming space for FES exercise equipment and participants in their fitness facility.

Since 2008, the Saville Centre has actively engaged in TSC’s  Community Exercise Transition initiative providing an inclusive environment, access to regular and adapted exercise equipment for community members experiencing disability to work out. 

The Spinal Cord Injury Treatment Centre Society (SCITCS) contributed $50,480 to secure a half time position over two years and purchase a data line for the equipment.  Additionally, SCITCS provided two pieces of equipment (the RT300 FES Cycle and the RT200 FES elliptical) for use by the program. SCITCS has supported FES at TSC since 1991.

University of Alberta students gained valuable experience through practicum and clinical placements, and as volunteers, including 18 student volunteers from the Spinal Cord Injury Students' Association. 

The FES Community Exercise Project ran from 2011 to 2013, and successfully transitioned 28 participants to the Saville Centre. Wait times have been eliminated (there is room for new participants) and participants in FES have a choice about how, when, and where they want to exercise. An added plus is the opportunity to exercise alongside friends and family, in a community setting. 

Testimonial

 Shirleyanne Michaels was originally diagnosed with MS in 1974.  She continued with her work, but lost mobility as the years progressed.  By 1990, Michaels was unable to walk. By 2012, complications from a broken hip in 2007 and a fall in 2010 resulted in considerable fluid on her body and legs. Michaels found out about the FES exercise Community project in the fall of 2012 and started using the FES equipment in November 2012. With a short pause over Christmas, Michaels participated in FES exercise three times a week: Monday, Wednesday and Friday for one hour each day.

"My strength and endurance increased each week. As an added plus, I started losing fluid," said Michaels, who noted that the FES exercise seemed to have a positive effect on fluid loss. (A hypothesis is that the muscle action improves the blood flow, reducing the venous insufficiency, but it is not known if this is a common observation.) Michaels was able to reduce pain medication (for nerve injuries as a result of a fall), and gained more movement.  "I find now when I am riding my mobility scooter, I last for a longer time period [2 to 3 hours] of before I feel tired.

Michaels is in Australia at the moment, but when she returns to Edmonton in 2014, she plans to continue with FES exercise. "I think the way it is available with its extended hours of availability is a definite plus, and I can see it being of benefit to many people."

Community Exercise Transition model and programs
The Steadward Centre actively engages with communities across Alberta and Canada to enable accessibility and physical activity for individuals experiencing disability. Community Exercise Transition (CET)program provides facility assessments, staff training, and works one-on-one with individuals living with impairment as they gain the skills and confidence to work out at facilities in their community. If you are interested in CET for yourself, a family member or your community, please contact Bobbi-Jo Atchison. Services available are: assessments, adapted physical activity training, program development, presentations and consulting.
Benefits of FES
FES

provides many benefits to many individuals who are suffering from Multiple Sclerosis, stroke, or spinal cord injury. FES exercise can help to prevent cardiovascular disease, type two diabetes and circulatory challenges. It also provides emotional benefits such as improved self-esteem and self-efficacy.

  • A total of 65 assessments were completed for individuals interested in participating in either the TSC University based program or the TSC community based program. Thus eliminating the wait times for people to access FES exercise within the Capital Region.
  • A total of 37 individuals living with paralysis participated in the Community FES Exercise Program. Currently there are 28 active users including 18 individuals experiencing spinal cord injury, 4 with stroke, 5 living with multiple sclerosis and 1 living with spina bifida. 
  • An electrode purchasing program was implemented for individuals to purchase electrodes for personal use.
  • Community collaborations were forged and/or strengthened with a variety of organizations including: Restorative Therapies, Uro Medical Supplies and the Glenrose Rehabilitation Hospital. 
  • TSC staff received training from Restorative Therapies.
  • Teaching and learning opportunities were provided to 6 students through full-time practicum placements, clinical placements and course work. An additional 7 students received applied learning experiences through volunteer placements. Eighteen students from the Spinal Cord Injury Students Association received training to support in the programs.