Outcomes After Functional Electrical Stimulation Cycle Training in Individuals with Multiple Sclerosis Who Are Nonambulatory.

BACKGROUND: Exercise is safe and beneficial for people with multiple sclerosis (MS). Functional electrical stimulation (FES) cycling offers people with significant weakness and mobility challenges an option for exercise. We sought to evaluate the safety of FES cycling and its potential to improve fatigue, pain, spasticity, and quality of life in people with moderate-to-severe MS. METHODS: Sixteen participants with MS who were nonambulatory cycled for 30 minutes two to three times a week for 1 month. Outcomes assessed included MS Quality of Life Inventory (MSQLI) subscales, Modified Ashworth Scale (MAS), and manual muscle test (MMT). RESULTS: Fourteen participants (six women and eight men) with MS completed the training. All were able to maintain or increase their cycle time; half increased the resistance while cycling. Participants demonstrated a significant decrease in the Physical (P = .02) and Psychosocial (P < .01) subscales of the Modified Fatigue Impact Scale. There was no significant change in the other MSQLI subscale scores. There was no change in MAS and MMT scores. Type of MS and the use of antispasticity medications, disease-modifying therapies, or dalfampridine did not seem to influence response to training. There were no adverse events. CONCLUSIONS: Functional electrical stimulation cycling may be a viable and effective exercise option 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 MS symptoms and to fully explore the potential benefits of optimizing function and improving health in people with MS.

Pilot study: evaluation of the effect of functional electrical stimulation cycling on muscle metabolism in nonambulatory people with multiple sclerosis.

OBJECTIVE: To investigate the changes in muscle oxygen consumption (mV˙O2) using near-infrared spectroscopy (NIRS) after 4 weeks of training with functional electrical stimulation (FES) cycling in nonambulatory people with multiple sclerosis (MS). DESIGN: Four-week before-after trial to assess changes in mV˙O2 after an FES cycling intervention. SETTING: Rehabilitation hospital. PARTICIPANTS: People (N=8; 7 men, 1 women) from a volunteer/referred sample with moderate to severe MS (Expanded Disability Status Scale score>6.0). INTERVENTION: Participants cycled 30 minutes per session, 3d/wk for 4 weeks or a total of 12 sessions. MAIN OUTCOME MEASURES: mV˙O2 of the right vastus lateralis muscle was measured with NIRS before and within 1 week after the intervention. Six bouts of 15-second electrical stimulation increasing from 2 to 7Hz were used to activate the muscle. mV˙O2 was assessed by analyzing the slope of the NIRS oxygen signal during a 10-second arterial occlusion after each electrical stimulation bout. RESULTS: Significant FES training by electrical stimulation frequency level interaction was observed (P=.031), with an average increase in mV˙O2 of 47% across frequencies with a main effect of training (P=.047). CONCLUSIONS: FES cycling for 4 weeks improved mV˙O2, suggesting that FES cycling is a potential therapy for improving muscle health in people with MS who are nonambulatory.