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Training Effects and Safety of Functional Electrical Stimulation (FES) Cycling in People With Multiple Sclerosis

      Objective

      To evaluate safety, and the potential for FES cycling to improve fatigue, pain, spasticity and perceived quality of life, in people with moderate to severe MS.

      Design

      Quasi-experimental pre-post Design.

      Setting

      Non-profit rehabilitation hospital.

      Participants

      People with multiple sclerosis and EDSS scores ≥ 6.0.

      Interventions

      Participants trained on the RT-300 FES cycle (Restorative Therapies, Inc., Baltimore, MD) 2-3 times a week for 4 weeks. Each cycled at 35-50 rpm for 30 minutes, either with their own volition or with electrical stimulation for assist. Intensity of FES was adjusted for each participant based on comfort.

      Main Outcome Measure(s)

      Collected immediately before and after the 4-week intervention: MS Quality of Life Inventory (MS QLI) subscales, Modified Ashworth Scale (MAS, spasticity), Paced Auditory Serial Addition Test (PASAT, cognitive processing speed) and manual muscle test (MMT, strength). Data was also collected after each training session to monitor progress on the cycle, and for any changes in status.

      Results

      Fourteen participants (8 male) with MS completed the training. All were able to either maintain or increase the amount of time they could cycle; half (7/14) were able to increase the resistance against which they cycled. Participants demonstrated a significant increase in cognitive processing speed (PASAT; p<0.001), and a significant decrease in pain (MOS Pain Effects Scale; p<0.02). In addition, there was a statistically significant decrease in the physical subscale of the Modified Fatigue Impact Scale (p=0.01) and the psychosocial subscale (p=0.01). There was no significant change in the other subscales of the MS QLI. There was neither a significant increase nor decrease in MAS and MMT scores. There were no adverse events, or worsening of MS symptoms.

      Conclusions

      FES cycling may be a viable and effective option of exercise for people with moderate to severe MS. Further study is required to examine the parameters of FES cycling that are most effective for people with different constellations of MS symptoms, and to fully explore the potential benefits for optimizing function and improving health in people with MS.

      Key Words

      multiple sclerosis, FES, functional electrical stimulation

      Disclosure(s)

      None Disclosed.