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Effectiveness of Functional Electrical Stimulation on Walking Speed, Functional Walking Category, and Clinically Meaningful Changes for People With Multiple Sclerosis

Published:December 11, 2014DOI:https://doi.org/10.1016/j.apmr.2014.11.017

      Abstract

      Objective

      To determine the effectiveness of functional electrical stimulation (FES) on drop foot in patients with multiple sclerosis (MS), using data from standard clinical practice.

      Design

      Case series with a consecutive sample of FES users collected between 2008 and 2013.

      Setting

      Specialist FES center at a district general hospital.

      Participants

      Patients with MS who have drop foot (N=187) (117 women, 70 men; mean age, 55y [range, 27–80y]; mean duration since diagnosis, 11.7y [range, 1–56y]). A total of 166 patients were still using FES after 20 weeks, with 153 patients completing the follow-up measures.

      Interventions

      FES of the common peroneal nerve (178 unilateral, 9 bilateral FES users).

      Main Outcome Measures

      Clinically meaningful changes (ie, >.05m/s and >0.1m/s) and functional walking category derived from 10-m walking speed.

      Results

      An increase in walking speed was found to be highly significant (P<.001), both initially where a minimum clinically meaningful change was observed (.07m/s) and after 20 weeks with a substantial clinically meaningful change (.11m/s). After 20 weeks, treatment responders displayed a 27% average improvement in their walking speed. No significant training effect was found. Overall functional walking category was maintained or improved in 95% of treatment responders.

      Conclusions

      FES of the dorsiflexors is a well-accepted intervention that enables clinically meaningful changes in walking speed, leading to a preserved or an increased functional walking category.

      Keywords

      List of abbreviations:

      AFO (ankle-foot orthosis), FES (functional electrical stimulation), MS (multiple sclerosis)
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