Medal-winning paralysed cyclist aims to raise £1 million for spinal stimulation research

A paraplegic cyclist has utilised the power of Functional Electrical Stimulation (FES) to pedal his way to second place at the annual Cybathlon. Now, he’s embarking on another journey to raise £1 million to fund research on spinal stimulation; a treatment method which aims to improve the recovery and function of people with paralysis.

Following a trampolining accident in 2011 at the age of 16, Johnny Beer (AKA BionicBeer), was paralysed from the chest down.

Almost ten years later, the 25-year-old has snatched the silver medal at the Cybathlon 2020 FES Bike Race. BionicBeer powered his bike using Functional Electrical Stimulation (FES), a method which contracts paralysed muscles using small electrical charges.

Electrodes are placed on the skin through which an electrical current is passed. This effectively replaces the nervous system stimulus that is lost when someone is paralysed.

This year, due to the COVID-19 pandemic, the Cybathlon race took place virtually with competitors racing 1,200 metres in stationary bikes connected to roller trainers. As Beer is unable to use his hands, he competed in a recumbent bike designed by BerkelBike and controlled the bike and level of electrical simulation using his chin.

Beer wasn’t alone in the competition and his success has been described as a team effort between himself and several companies. The applied science team at Mercedes F1 played an integral role in the development of the bike set up and the carbon fibre cycling boots which powered Beer to the runner-up position.

The involvement of the German automotive company originated from a chance encounter with Eric Blandin, Mercedes’ chief aerodynamicist, when Johnny was touring its factory.

“Eric was immediately interested and supportive,” says Johnny.  “Within days, he had spoken to the team’s Applied Science Division and assembled an interested group of amazing engineers to build carbon fibre boots, a heightened axle for larger wheels with custom made hubs, ceramic bearings and optional Camber adjustment.

“The team’s Applied Science engineers were always just an email away and I couldn’t have wished for a better team in my corner.”

Graham Miller, Director of Applied Science at Mercedes F1 says: “We are delighted and very proud to have been able to help Johnny on his route to success in the Cybathlon 2020.

“Our Applied Science Division was set up earlier this year to use our vast engineering knowledge and resources to help deliver innovative technical solutions to businesses and individuals.

“Working with Johnny has been both rewarding and a real technical challenge for our team, applying their F1 knowledge to new areas. His spirit, commitment and dedication to helping others are fantastic.”

Beer had previously won a silver medal at the 2016 edition of the Cybathlon event and won the Cyberbike 2018 time trials in France. His main rival this year was Mark Muhn, winner of the 2016 Cybathlon, who used surgically implanted electrodes as opposed to the adhesive electrodes used by BionicBeer.

Since winning the silver medal, Beer has turned his attention to spinal stimulation research with the goal of further improving his and others’ recovery. He is supporting Neurokinex, a specialist spinal cord injury rehabilitation facility and charity which has treated him since his injury.

Neurokinex also aided Beer in his physical preparation for the race, creating an FES leg weightlifting programme to help him make full use of the technology.

“Johnny is an incredible individual whose energy, enthusiasm and determination is unmatched,” says Harvey Sihota, founder and CEO of Neurokinex.  “Since the day we met, he has inspired others to share his vision to progress his dream of regaining mobility and independence.

“At Neurokinex we use electrical stimulation alongside many other ground-breaking therapies.  As well as our rehabilitation programmes, we are committed to researching next-generation therapies and solutions to treat spinal cord injury.

“People like Johnny are vital to that process and we are hugely grateful to him for giving so much of his time and energy to seek solutions for other people.”

Beer had his sights set on a place on the podium, however his primary motivation for competing was to raise funds for research into spinal stimulation and increase awareness about electrical stimulation and its potential for helping people regain movement and independence.

“While I love the competition and thrill of racing, my priority is to drive research for electrical stimulation by competing in Cybathlon 2020,” says Beers. “My dream is to recover from paralysis, and I want this to become reality so badly.

“Electrical stimulation has powered me to race at the highest level and its potential to provide practical recovery solutions for others cannot be ignored.

“As with so much in spinal cord injury rehab, the science is ahead of the money here. Lack of funding is getting in our way which is why I’m going all out to raise £1 million to make this possibility a reality.”

Odstock Medical Ltd (OML), a spin-out company from the Salisbury NHS Foundation Trust, specialises in FES technology. It works with patients with spinal cord injuries to help them stand, treat chronic pain and control spasticity. In an interview with Health Tech World, managing director of OML, Paul Taylor, spoke of the barriers to making FES a more widely used treatment.

“It’s a recommended treatment for the NHS but not everyone chooses to fund it,” says Taylor. “FES is generally used by a physiotherapist for controlling spasticity and controlling movement. However, because physiotherapists usually don’t have the budget for equipment, it doesn’t fit into the general funding model of the NHS.

“The published reasons for this are that there is insufficient evidence regarding the cost benefits of the technique. At the end of the day, CCGs are trying to save money, however many of the published evidence uses statements that are out of date.”

A recent randomised clinical trial at the Ayrshire General Hospital in Scotland found that FES was in fact more cost effective than the widely used alternative, ankle foot orthosis (AFO). It found that while AFOs were initially cheaper, the FES provided better improvements in overall quality of life.

The most successful use of FES in a clinical setting is for treating a condition called drop foot, a muscular weakness or paralysis commonly experienced by patients with neurological conditions such as stroke, MS and cerebral palsy.

The concept has existed since the 1960s but has failed to be adopted in clinical practice until recently. Even with access to the treatment is still limited.

Taylor says: “Currently you can’t live in one place and get immediate access to FES treatment. Unfortunately, you have to jump through a few hoops in many areas and in some areas it’s a complete no. There’s no consistency across the country.”

In addition to its applications for treating foot drop, FES has been shown to improve hand, arm and shoulder function in stroke patients by strengthening muscles around the shoulder. Although this may not bring back movement, but it can significantly reduce chronic pain. It can also be used for improving elbow movement and finger movement by reducing spasticity.

In recent years, OML has been finding innovative new applications for the technique. For example, Taylor says the company has discovered a way to treat constipation, a common problem amongst people with neurological issues. Some people report only making bowel movements every week, however after stimulating the abdominal muscles using FES, patients reported that their frequency of bowel movements increased to every one or two days.

The company’s latest project is a hand-grasping system for people with tetraplegia. The project is in its early stages but has the potential to allow paralysed patients to pick up and move objects.

Taylor explains: “It is like a long sleeve glove with electrodes on the inside and it is controlled by movements in the opposite shoulder. You can programme it to open the hand, close it around an object, and then open the hand again to drop the object.”

A growing body of published research and increased interest from patients such as Beer is driving the FES sector forward. Beer hopes his campaign will show more people the potential of the treatment and shine a light on the work of Neurokinex who “threw him a lifeline” after his injury.

“I cannot thank everyone enough for their support,” says Beer.  “The collaboration and belief among everyone has been incredible and I can only hope that such enthusiasm and foresight will continue after the race to back the Neurokinex Spinal Stimulation Research Programme.  That remains the ultimate goal with my performance at Cybathlon 2020 showing what can be done with electrical stimulation.”