ABSTRACT
BACKGROUND: Functional electrical stimulation (FES) cycling is used by spinal cord injury patients to facilitate neurologic recovery and may also be useful for progressive MS patients. OBJECTIVE: To evaluate the safety and preliminary efficacy of home FES cycling in progressive MS and to explore how it changes cerebrospinal fluid (CSF) cytokine levels. METHODS: Five patients with primary or secondary progressive MS were given an FES cycle for six months. Main outcome measures were: Two Minute Walk Test, Timed 25-foot Walk, Timed Up and Go Test, leg strength, Expanded Disability Status Scale (EDSS) score, and Multiple Sclerosis Functional Composite (MSFC) score. Quality-of-life was measured using the Short-Form 36 (SF-36). Cytokines and growth factors were measured in the CSF before and after FES cycling. RESULTS: Improvements were seen in the Two Minute Walk Test, Timed 25-foot Walk, and Timed Up and Go tests. Strength improved in muscles stimulated by the FES cycle, but not in other muscles. No change was seen in the EDSS score, but the MSFC score improved. The physical and mental health subscores and the total SF-36 score improved. CONCLUSIONS: FES cycling was reasonably well tolerated by progressive MS patients and encouraging improvements were seen in walking and quality-of-life. Larger studies of FES cycling in progressive MS are indicated.
Subject(s)
Electric Stimulation Therapy , Multiple Sclerosis, Chronic Progressive/rehabilitation , Muscle Strength , Quality of Life , Recovery of Function , Walking , Adult , Cytokines/cerebrospinal fluid , Disability Evaluation , Electric Stimulation Therapy/instrumentation , Electric Stimulation Therapy/methods , Exercise Test , Female , Humans , Intercellular Signaling Peptides and Proteins/cerebrospinal fluid , Leg/physiopathology , Male , Middle Aged , Multiple Sclerosis, Chronic Progressive/cerebrospinal fluid , Multiple Sclerosis, Chronic Progressive/physiopathology , Pilot Projects , Time Factors , Treatment OutcomeABSTRACT
Separation of single-wall carbon nanotubes (SWCNTs) by length via centrifugation in a high density medium, and the characterization of both the separated fractions and the centrifugation process are presented. Significant quantities of the separated SWCNTs ranging in average length from <50 nm to approximately 2 microm were produced, with the distribution width being coupled to the rate of the separation. Less rapid separation is shown to produce narrower distributions; these length fractions, produced using sodium deoxycholate dispersed SWCNTs, were characterized by UV-visible-near-infrared absorption and fluorescence spectroscopy, dynamic light scattering, Raman scattering, and atomic force microscopy. Several parameters of the separation were additionally explored: SWCNT concentration, added salt concentration, liquid density, rotor speed, surfactant concentration, and the processing temperature. The centrifugation technique is shown to support 10 mg per day scale processing and is applicable to all of the major SWCNT production methods. The cost per unit of the centrifugation-based separation is also demonstrated to be significantly less than size exclusion chromatography-based separations.
