RT300 for spinal cord injury rehabilitation

Level of innovation

One expert said the RT300 was highly innovative by allowing quick multichannel stimulation, but noted that other functional electrical stimulation (FES) bikes with similar advantages are on the market. Another commentator, who works in a specialised spinal unit, said FES cycling is now considered standard practice for inpatient spinal cord injury rehabilitation and had used it for over 10 years. They added that it could still be considered novel in other spinal units or clinical specialities where there was less familiarity with FES technology. One commentator said the main innovation is being able to stimulate multiple muscles against a resistance in the same treatment session, which saves therapist time. A further commentator noted the RT300 was innovative because it can be used with the patient in a supine position. Some people with spinal cord injury have autonomic dysfunction, resulting in exercise‑related hypotension. Other technologies did not offer this innovation.

Potential patient impact

Experts noted that RT300 allows muscles to be exercised that otherwise could not be in people with spinal cord injury. Two experts considered that RT300 could help recovery of voluntary muscle power if the patient has the neurological potential to improve. Such improvement in muscle power could have a positive effect on patients' functional ability to improve their independence. An expert stated that the use of the RT300 in children with spinal cord injury could help to develop awareness of their limbs and provide patterned muscle activities that maintain muscle bulk while the child learns to move voluntarily. This expert also noted that the RT300 ability to link to a database allowed people to access treatment at home.

Experts considered that the use of the technology could potentially reduce secondary complications and hospital admissions. They also considered that RT300 allowed people with spinal cord injury to exercise their unused muscles, and provided them an opportunity to improve their cardiovascular fitness. This then reduces the risk of secondary cardiovascular conditions. One expert felt the FES cycle could be the most effective way to maintain the health of paralysed limbs in people with spinal cord injury. They added that the muscle torque generated can be enough to stimulate bone growth, which will help maintain a healthier bone density if training is set at a high level.

Potential system impact

Two experts considered that more staff would be needed to support patients during treatment sessions. Another expert felt there would be a need for staff training to allow them to fully understand the potential applications and benefits of RT300. One expert noted sites adopting RT300 would need extra space to accommodate the devices in rehabilitation settings.

One expert considered that the technology would reduce hospital admission by reducing secondary complications of spinal cord injury. However they did not feel there would be real cost benefits for some time because of the availability and uptake of the technology in rehabilitation settings. Another expert noted the technology would add extra cost compared with standard care, and did not feel it would have a substantial effect on overall length of stay for a patient in a spinal injuries unit.

General comments

One expert considered that RT300 has become core to spinal cord injury rehabilitation in their practice but the adoption of the technology may be limited because of funding availability for rehabilitation care. This expert also noted that FES cycling would not be suitable for all people with spinal cord injury, and an assessment including people's ability to respond to electrical stimulation should be made before treatment. One expert felt the adoption of RT300 may be delayed because of a lack of knowledge of how to use the technology.