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Here, we present an overview of these secondary life\u2010threatening conditions, discuss the rationale behind the development of a hybrid exercise called FES rowing, and describe our experience in developing FES rowing technology. FES rowing and sculling are unique forms of adaptive rowing for those with SCI. The paralyzed leg musculature is activated by multiple channels of electrical pulses delivered via self\u2010adhesive electrodes attached to the skin. The stimulated muscle contractions are synchronized with voluntary rowing movements of the upper limbs. A range of steady\u2010state FES rowing exercise intensities have been demonstrated from 15.2\u2009\u00b1\u20091.8 mL\/kg\/min in tetraplegia to 22.9 \u00b17.1 mL\/kg\/min in paraplegia. We expect that such high levels may help some to achieve significant reductions in the risks to their health, particularly where a dose\u2010response relationship exists as is the case for cardiovascular disease and Type II diabetes. Furthermore, preliminary results suggest that cyclical forces more than 1.5 times body weight are imposed on the leg long bones which may help to reduce the risk of fragility fractures. We have demonstrated the feasibility of FES rowing on land and water using adapted rowing technology that includes; a fixed stretcher indoor ergometer (adapted Concept 2, Model E), a floating stretcher indoor ergometer (adapted Concept 2 Dynamic), a turbine powered water rowing tank, a custom hydraulic sculling simulator and a single scull (adapted Alden 16). This has involved volunteers with paraplegia and tetraplegia with SCI ranging from C4 to T12 AIS A using at least 4\u2010channels of surface electrical stimulation. FES rowers, with SCI, have competed alongside non\u2010SCI rowers over the Olympic distance of 2000 m at the British Indoor Rowing Championships in 2004, 2005, and 2006 and the World Indoor Rowing Championships in 2006 (CRASH\u2010B's) in Boston, MA, USA. The best 2000 m FES rowing performance to date has been achieved by a 23\u2010year\u2010old male, Tom Aggar T12 AIS A, in 10 min 28 s. Moreover, two of our FES rowers with complete paraplegia have gone on to successfully compete in the Adaptive Rowing arms\u2010only category (AM1x) at the World Rowing Championships and Paralympic Games.<\/jats:p>","DOI":"10.1111\/aor.13053","type":"journal-article","created":{"date-parts":[[2017,11,17]],"date-time":"2017-11-17T08:35:15Z","timestamp":1510907715000},"source":"Crossref","is-referenced-by-count":26,"title":["Development of Functional Electrical Stimulation Rowing: The Rowstim Series"],"prefix":"10.1111","volume":"41","author":[{"given":"Brian","family":"Andrews","sequence":"first","affiliation":[{"name":"School of Engineering University of Warwick Coventry UK"},{"name":"Nuffield Department of Surgical Sciences University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Gibbons","sequence":"additional","affiliation":[{"name":"CREATe University College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garry","family":"Wheeler","sequence":"additional","affiliation":[{"name":"MS Society of Alberta Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,17]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e31802f0247"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1310\/sci1301-98"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0079-6123(05)52014-4"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2010.70"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.2174\/1381612811319240009"},{"key":"e_1_2_5_7_1","first-page":"133","article-title":"Cardiac dysfunctions following spinal cord injury","volume":"2","author":"Grigorean VT","year":"2009","journal-title":"J Med Life"},{"key":"e_1_2_5_8_1","first-page":"275","article-title":"Vascular dysfunctions following spinal cord injury","volume":"3","author":"Popa C","year":"2010","journal-title":"J Med Life"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NPT.0000282514.94093.c6"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.2174\/1568016043477242"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-005-2028-8"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.1995.140"},{"key":"e_1_2_5_13_1","first-page":"225","article-title":"Bone mineral and geometric changes through the femur with immobilization due to spinal cord injury","volume":"37","author":"Kiratli BJ","year":"2000","journal-title":"J Rehabil Res Dev"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.1995.141"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2014.08.948"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2004.01.001"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034510377791"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-003-1529-6"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.09.006"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.11.062"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2005.02.0036"},{"key":"e_1_2_5_22_1","first-page":"227","article-title":"Asymmetric bone adaptations to soleus mechanical loading after spinal cord injury","volume":"8","author":"Dudley\u2010Javoroski S","year":"2008","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-011-1879-4"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7580.2009.01201.x"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcb.25265"},{"key":"e_1_2_5_26_1","unstructured":"AndrewsBJ ShippenJ ArmengolM GibbonsRS HolderbaumW HarwinW.A design method for FES bone health therapy in SCI.Proceeding of International FES Society Scientific Meeting 8\u201310th June 2016 La Grande\u2010Motte France."},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.16.1994"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200131150-00002"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(99)90331-3"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e318213fefb"},{"key":"e_1_2_5_31_1","first-page":"29","article-title":"Wheelchair user's shoulder? 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