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CHKD patient Ian Balutis using the new rehab bike.

New Therapy Bike at CHKD Uses Electrical Pulses to Stimulate Muscles

By Elizabeth Early, CHKD Staff Writer

As Ian Balutis pumps the arm cranks of a therapy bike, a line on the computer panel before him beams bright yellow.

That tells him he’s not just working muscles in his arms. Electrodes placed on his back and stomach are also sending electrical pulses to stimulate his core muscles, helping him regain strength there as well.

This is no ordinary bike. It’s called a functional electrical stimulation therapy bike, and it’s the newest piece of bioscience equipment at CHKD’s inpatient rehabilitation unit.

It works by sending small electrical pulses to paralyzed muscles to restore or improve their function. Besides exercising his arms, Ian’s movements are sending electrical impulses that contract muscles throughout his core. A computer panel programs which muscles to stimulate, and measures Ian’s efforts.

Kelly Allen, Ian’s occupational therapist, said the bike arrived at CHKD in January. It’s designed to help patients with spinal cord injuries, paralysis, multiple sclerosis, and other neuromuscular conditions by boosting heart and lung function, improving strength and circulation, and building muscle mass. The electrodes are placed on different parts of the body depending on what needs strengthening.

Ian, who is 18, uses the arm cycling during occupational therapy to strengthen core muscles in his stomach and back. Pumping the bottom pedals helps stimulate muscle contractions in his legs to build muscle there.

In combination with other therapy and medical treatment, he feels like his core muscles have strengthened, allowing him to sit straighter and breathe easier.

Ian is a high school senior from Arlington, who started feeling tingling in his feet and legs in late August. That feeling quickly moved up his body, leaving him weak and then unable to move. His condition deteriorated so rapidly, he needed to be intubated and put on a ventilator at Inova Fairfax hospital.

He stayed there more than two months, most of the time in an induced coma while tests were done to figure out what was causing the paralysis.

Doctors believe an infection set off an immune response that caused inflammation of the spinal cord. He was discharged from Inova in mid-November, but still needed rehabilitation.

The inpatient rehab unit at CHKD accepts a wide array of medically complex patients and can accept patients on ventilators. Many inpatient rehab centers do not have this capacity, so CHKD quickly surfaced as the place to go so Ian could start his intensive rehabilitation while still on the ventilator. 

CHKD is the only inpatient rehab facility for pediatric patients in the state, and a multidisciplinary team helps patients recover from strokes, traumatic brain injuries, neuromuscular diseases, spinal cord injuries, and numerous other conditions. The FES bike is just one in an array of the latest biotechnical equipment in the unit, which cares for patients throughout Virginia and surrounding states. "At CHKD, our inpatient rehabilitation program combines the latest in technology with therapy and medications to help patients regain abilities and maximize their qualify of life," said Dr. Rianna Leazer, a pediatric hospitalist who is medical director of CHKD's inpatient rehab unit.

Therapists, doctors, and other healthcare providers have worked together to wean Ian off the vent and help him regain motion and strength.

“I’m able to hold myself up, I’m very much more of a person, working my core, getting more rotation. A lot of rehab is not just regaining function but working with what you have.”

He gives the therapy bike high marks, and his therapists are looking into options for him to have one for home use. “It seems like I notice more immediate improvement in stability after I use it.”

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