Multi-Intensity Lower Limb Training with Optimized Neurorehabilitation using Functional Electrical Stimulation (MILTON – FES)


Daniel S. U. Tamashiro, University of Sao Paulo Medical School General Hospital (IMREA-HCFMUSP)


The MILTON system is a highly effective solution for individuals with neurological impairments looking to achieve their therapeutic goals through multi-intensity lower limb training with functional electrical stimulation. Specifically designed for patients with a complete spinal cord injury at the cervical or high thoracic level, MILTON incorporates an exercise bike (ergometer) that integrates functional electrical stimulation (FES) with task-specific or motor assistance/resistance activities to optimize therapeutic outcomes. The acronym MILTON stands for “Multi-Intensity Lower Limb Training with Optimized Neurorehabilitation using Functional Electrical Stimulation on an Ergometer.”
By utilizing functional electrical stimulation in the cycle ergometer, MILTON produces sequential contractions of the lower limb muscles, reproducing the pedaling motion of the bike. This coordinated stimulation method enables patients to experience an adaptive response with training, allowing them to gradually increase their resistance to the pedaling motion and improve their cardiovascular conditioning. One of the primary benefits of the MILTON system is its ability to combat physical inactivity and muscle atrophy in individuals with spinal cord injury, leading to better cardiovascular health.
The system’s proprietary software provides real-time biofeedback and data tracking, optimizing training and helping patients achieve their therapeutic goals. Its sophisticated control algorithms are designed specifically for a wide range of neurological impairments, providing customized training that can adapt to
each patient’s unique needs. The MILTON system also features a motivational extended reality graphical interface tablet, designed to keep patients engaged and motivated throughout their training.
Additionally, the MILTON system can be attached to a multiparameter monitor to collect vital health information during the exercise, including heart rate, oxygen saturation levels, arterial pressure, and temperature. By collecting this data during training sessions, healthcare professionals can gain valuable insights into how the patient’s body is responding to the therapy and adjust training plans accordingly. Monitoring vital signs during training sessions is particularly important for individuals with neurological impairments, as they may be at a higher risk for complications such as autonomic dysreflexia. With the ability to monitor vital signs in real-time, healthcare professionals can quickly identify any potential issues and take appropriate action to prevent complications.
Finally, the MILTON system includes a web platform that enables healthcare professionals to monitor and record patient activities and exercises remotely. This feature provides important insights into patient progress, allowing clinicians to adjust training plans and optimize outcomes.
Overall, the MILTON system is a comprehensive and sophisticated solution for multi-intensity lower limb training with functional electrical stimulation, designed to help individuals with neurological impairments achieve their therapeutic goals and improve their quality of life. With its innovative approach, proprietary software, and vital sign monitoring capabilities, the MILTON system provides safe and effective therapy that is customized to each patient’s unique needs.