Functional electrical stimulation-assisted cycling of patients with multiple sclerosis: biomechanical and functional outcome--a pilot study

Abstract

Objective: To determine whether functional electrical stimulation-supported ergometric training of patients with multiple sclerosis has a prosthetic or therapeutic effect on biomechanical (power, smoothness of cycling) and functional outcomes (walking capability, strength of muscle, spasticity).

Design: Twelve subjects with multiple sclerosis participated in an electrical stimulation-supported ergometric training (3 sessions/week for 2 weeks). Measurements were made in a cross-over design to study prosthetic (with and without stimulation) and therapeutic effects (before and after training).

Methods: Power and smoothness were calculated by cadence and torque recordings of cycling and spasticity; strength and walking capability were measured by the Modified Ashworth Scale, Manual Muscle Test, and 10-Metre Walk Test.

Results: The power and smoothness of pedalling significantly improved prosthetically with electrical stimulation (p=0.02), but did not show significant improvement over the 2 weeks of training. Significant short-term reductions in spasticity (before vs after training session; p<0.05) were found. Isometric strength did not increase significantly during the 2-week training period and there was no improvement in walking ability.

Conclusion: Patients with multiple sclerosis are able to improve their cycling power and smoothness by pedalling with stimulation. We suggest that severely affected patients benefit more from functional electric stimulation-cycling therapy than do slightly affected patients.