Highlights
- •Hybrid functional electrical stimulation (FES) exercise combines arm cranking with FES leg cycling.
- •Hybrid FES exercise has not previously been investigated in people with multiple sclerosis (MS).
- •FES intensity during hybrid FES exercise was sufficient to enhance aerobic response.
- •Regular hybrid FES exercise might improve aerobic fitness in people with advanced MS.
Abstract
Objective
To investigate through a pilot study the acute cardiorespiratory responses during
functional electrical stimulation (FES) cycling, arm crank ergometry (ACE), and a
combination of ACE and FES cycling (hybrid FES cycling) in people with advanced multiple
sclerosis (MS) to provide preliminary guidance for effective aerobic exercise prescription.
Design
Acute repeated measures.
Setting
Laboratory setting.
Participants
Inclusion criteria was a diagnosis of MS, with Expanded Disability Status Scale (EDSS)
6.0-8.5. Included were 9 participants (N=9; 7 female, age 54.7±8.8y, EDSS 7.2±0.7).
Interventions
Participants were assessed on 3 different exercise modalities (FES cycling, ACE, hybrid
FES cycling) at 40%, 60%, 80%, and 100% of mode-specific peak workload.
Main Outcome Measures
Oxygen consumption and heart rate were measured at each workload.
Results
Hybrid FES cycling evoked a significantly higher oxygen consumption relative to body
weight (V̇o2relative) (mL/kg/min) and heart rate (beats per minute [BPM]) at most workloads compared
with ACE or FES cycling. At the 100% workload, heart rate for hybrid FES cycling was
125 BPM (range, 113-148 BPM) and was significantly higher than ACE at 99 BPM (range,
95-119 BPM) (P=.008) and FES cycling at 94 BPM (range, 79-100 BPM) (P=.008). Similarly, at the 100% workload, V̇o2relative for hybrid FES cycling was 11.8 mL/kg/min (range, 7.6-17.6 mL/kg/min) and
was significantly higher than ACE at 8.9 mL/kg/min (range, 5.3-12.5 mL/kg/min) (P=.012) and FES cycling at 6.8 mL/kg/min (range, 4.1-9.2 mL/kg/min) (P=.012).
Conclusions
This pilot study showed that hybrid FES cycling can elicit a greater cardiorespiratory
response than ACE or FES cycling in people with advanced MS. Thus, hybrid FES cycling
might provide a potent enough stimulus to induce clinically relevant changes in cardiorespiratory
fitness. Training studies are warranted to document the magnitude and sustainability
of aerobic capacity adaptations to hybrid FES cycling and associated health outcomes
in advanced MS.
Keywords
List of abbreviations:
ACE (arm crank ergometry), BPM (beats per minute), EDSS (Expanded Disability Status Scale), FES (functional electrical stimulation), MS (multiple sclerosis), RPM (revolutions per minute), V̇o2 (oxygen consumption), V̇o2max (maximum oxygen consumption), V̇o2relative (oxygen consumption relative to body weight)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 17, 2021
Accepted:
July 12,
2021
Received in revised form:
May 28,
2021
Received:
February 16,
2021
Footnotes
Disclosures: none
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
