Functional Electrical Stimulation for Foot Drop in Multiple Sclerosis

US Neurology ◽  
2015 ◽  
Vol 11 (01) ◽  
pp. 10 ◽  
Author(s):  
Geraldine P Dapul ◽  
Francois Bethoux ◽  
◽  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Effective Treatment ◽  
Functional Electrical Stimulation ◽  
Treatment Strategy ◽  
Foot Drop ◽  
Walking Ability ◽  
Gait Performance

Functional electrical stimulation is an effective treatment strategy for the management of foot drop in various neurologic conditions, as demonstrated in improvements in gait performance, mobility, physiologic cost, perceived walking ability, balance, fall frequency, and quality of life. In this article, we review the current literature on the effects of functional electrical stimulation for foot drop in persons with multiple sclerosis.

scholarly journals Effect of a 2-Week Trial of Functional Electrical Stimulation on Gait Function and Quality of Life in People with Multiple Sclerosis

2014 ◽  
Vol 16 (3) ◽  
pp. 146-152 ◽  
Author(s):  
Abbey Downing ◽  
David Van Ryn ◽  
Anne Fecko ◽  
Christopher Aiken ◽  
Sean McGowan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Gait Speed ◽  
Walking Ability ◽  
Full Time ◽  
Short Period ◽  
The Impact

Background: Footdrop is a common gait deviation in people with multiple sclerosis (MS) leading to impaired gait and balance as well as decreased functional mobility. Functional electrical stimulation (FES) provides an alternative to the current standard of care for footdrop, an ankle-foot orthosis (AFO). FES stimulates the peroneal nerve and activates the dorsiflexor muscles, producing an active toe clearance and a more normal gait. This study was undertaken to determine the effects of a 2-week FES Home Assessment Program on gait speed, perceived walking ability, and quality of life (QOL) among people with MS-related footdrop. Methods: Participants completed the Timed 25-Foot Walk test (T25FW) and two self-report measures: 12-item Multiple Sclerosis Walking Scale (MSWS-12) and 29-item Multiple Sclerosis Impact Scale (MSIS-29). Measures were taken without FES before and with FES after 2 weeks of full-time FES wear. Results: A total of 19 participants (10 female, 9 male) completed the study; mean age and duration of disease were 51.77 ± 10.16 and 9.01 ± 7.90 years, respectively. Use of FES for 2 weeks resulted in a significant decrease in time to complete the T25FW (P < .0001), the MSWS-12 standardized score (P < .0001), and the MSIS-29 total (P < .0001), Physical subscale (P < .0001), and Psychological subscale (P = .0006) scores. Conclusions: These results suggest that use of FES can significantly improve gait speed, decrease the impact of MS on walking ability, and improve QOL in people with MS-related footdrop even over a short period of time.

scholarly journals Evaluating the Effect of Functional Electrical Stimulation Used for Foot Drop on Aspects of Health-Related Quality of Life in People with Multiple Sclerosis

2019 ◽  
Vol 21 (4) ◽  
pp. 173-182 ◽  
Author(s):  
Linda Miller Renfrew ◽  
Anna C. Lord ◽  
Jake Warren ◽  
Rebecca Hunter
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Performance Measure ◽  
Foot Drop ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background: Multiple sclerosis (MS) is a common degenerative neurologic condition resulting in walking difficulties. Foot drop is a common walking impairment in MS that can affect health-related quality of life (HRQOL). Functional electrical stimulation (FES) can improve walking in people with MS, but its effect on HRQOL is not well established. This review investigated the effect of FES used for foot drop on HRQOL in adults with MS. Methods: A systematic search was performed using CINAHL, MEDLINE, Cochrane Library, PubMed, and PEDro online databases. Inclusion and exclusion criteria were applied to select eligible studies. Data were extracted, and two reviewers independently rated the quality of the studies using the Effective Public Health Practice Project assessment tool. Results: Eight studies were eligible for review; seven were of moderate-to-strong methodological quality and one was weak. Seven studies demonstrated significant positive effects of FES on different aspects of HRQOL as measured by the 29-item Multiple Sclerosis Impact Scale, 36-item Short Form Health Status Survey, Canadian Occupational Performance Measure, and Psychosocial Impact of Assistive Devices Scale. Conclusions: This review provides preliminary evidence that FES has a positive effect on aspects of HRQOL in people with MS; however, the variety of HRQOL outcomes used makes it difficult to determine definitive conclusions. Future larger-scale randomized studies with long-term follow-up are recommended to better understand the effect of FES on HRQOL. This will inform prescribing decisions and support compliance with FES over the longer-term.

scholarly journals The Efficacy of Functional Electrical Stimulation of the Abdominal Muscles in the Treatment of Chronic Constipation in Patients with Multiple Sclerosis: A Pilot Study

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Christine Singleton ◽  
Abdel Magid Bakheit ◽  
Carla Peace
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Pilot Study ◽  
Transit Time ◽  
Functional Electrical Stimulation ◽  
Chronic Constipation ◽  
Abdominal Muscles ◽  
Related Quality

Chronic constipation in patients with multiple sclerosis (MS) is common and the current methods of treatment are ineffective in some patients. Anecdotal observations suggest that functional electrical stimulation (FES) of the abdominal muscles may be effective in the management of constipation in these patients.Patients and Methods. In this exploratory investigation we studied the effects of FES on the whole gut transit time (WGTT) and the colonic transit time (CTT). In addition, we evaluated the treatment effect on the patients’ constipation-related quality of life and on the use of laxatives and the use of manual bowel evacuation. FES was given for 30 minutes twice a day for a period of six weeks. Four female patients were studied.Results. The WGTT and CTT and constipation-related quality of life improved in all patients. The patients’ use of laxatives was reduced. No adverse effects of FES treatment were reported.Conclusion. The findings of this pilot study suggest that FES applied to the abdominal muscles may be an effective treatment modality for severe chronic constipation in patients with MS.

scholarly journals The effect of abdominal functional electrical stimulation on bowel function in multiple sclerosis: a cohort study

2020 ◽  
Vol 6 (3) ◽  
pp. 205521732094153
Author(s):  
Sophia D Lin ◽  
Jane E Butler ◽  
Claire L Boswell-Ruys ◽  
Phu D Hoang ◽  
Tom Jarvis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Standard Deviation ◽  
Functional Electrical Stimulation ◽  
Colonic Transit ◽  
Intervention Period ◽  
Transit Times ◽  
Related Quality

Background Chronic constipation is prevalent in people with multiple sclerosis, with current treatments usually only partially effective. Objectives This study aims to evaluate the efficacy of abdominal functional electrical stimulation to reduce whole gut and colonic transit times and improve bowel and bladder-related quality of life. Methods A total of 23 people with multiple sclerosis who fulfilled the Rome III criteria for functional constipation applied abdominal functional electrical stimulation for 1 hour per day, 5 days per week, for 6 weeks. Whole gut and colonic transit times and bowel and bladder-related quality of life were measured before and after the intervention period. Results Whole gut (mean 81.3 (standard deviation 28.7) hours pre vs. 96.1 (standard deviation 53.6) hours post-intervention, P = 0.160) and colonic transit time (65.1 (31.4) vs. 74.8 (51.1) hours, P = 0.304) were unchanged following 6 weeks of abdominal functional electrical stimulation. There was a significant improvement in bowel (mean 1.78 (SD: 0.64) pre vs. 1.28 (SD: 0.54) post, P = 0.001) and bladder (50.6 (26.49) vs. 64.5 (21.92), p = 0.007) related quality of life after the intervention period. Conclusion While abdominal functional electrical stimulation did not reduce whole gut and colonic transit times for people with multiple sclerosis, a significant improvement in bowel and bladder-related quality of life was reported.

scholarly journals Five-Year Follow-up of a Longitudinal Cohort Study of the Effectiveness of Functional Electrical Stimulation for People with Multiple Sclerosis

2018 ◽  
Vol 20 (5) ◽  
pp. 224-230 ◽  
Author(s):  
Tamsyn Street ◽  
Christine Singleton
Keyword(s):  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Joint Pain ◽  
Walking Speed ◽  
Foot Drop ◽  
Longitudinal Cohort ◽  
Significant Difference

Abstract Background: Few studies have examined the long-term consequences of using peroneal nerve functional electrical stimulation (FES) for people with multiple sclerosis (MS). This study examines orthotic effects on a longitudinal cohort and explores additional benefits of FES on self-reported measures such as joint pain. Methods: One hundred forty-five people with foot drop and MS were included (mean age, 52 [range, 28–74] years). Orthotic effects, unassisted walking speed, and clinically important differences (ie, ≥0.05 and ≥0.10 m/s) were derived from walking speed over 10 m. Visual analogue scales examined joint pain, walking effort, trips, confidence, and quality of life. Measures were taken on day 1, after 6 months, and at 2, 3, 4, and 5 years. Results: A significant difference was found overall for walking with FES compared with walking without FES for the 5-year period (P < .001). Despite a significant decline in overall unassisted walking speed at baseline (0.58 m/s) compared with 5 years later (0.46 m/s) (P < .001), participants achieved an orthotic effect with (0.52 m/s) versus without (0.46 m/s) FES after 5 years (P < .001). A significant decrease in joint pain was found after 6 months compared with day 1 (P = .004), which was maintained after 5 years (P < .001). Conclusions: Despite progression of MS, long-term users of FES still benefit from an orthotic effect after using FES for 5 years. The study highlights the need for further work to assess the perceived benefits of FES regarding the experience of joint pain.

scholarly journals Effects of Functional Electrical Stimulation on Gait Function and Quality of Life for People with Multiple Sclerosis Taking Dalfampridine

2015 ◽  
Vol 17 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Lori Mayer ◽  
Tina Warring ◽  
Stephanie Agrella ◽  
Helen L. Rogers ◽  
Edward J. Fox
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Physical Function ◽  
Functional Electrical Stimulation ◽  
Sf 36 ◽  
Gait Dysfunction ◽  
Gait Function ◽  
The Impact

Background: Multiple sclerosis (MS) can adversely affect gait, causing gait slowing, loss of balance, decreased functional mobility, and gait deficits, such as footdrop. Current treatments for gait dysfunction due to MS are pharmacologic, using dalfampridine, or orthotic, using an ankle-foot orthosis. Functional electrical stimulation (FES) to the fibular nerve stimulates active dorsiflexion and provides an alternative treatment for gait dysfunction caused by footdrop. The objective of this study was to determine the effect of FES on gait function and the impact of MS on walking and quality of life for people with MS taking a stable dalfampridine dose. Methods: Participants demonstrating gait slowing and footdrop completed the Timed 25-Foot Walk (T25FW) test, 6-Minute Walk (6MW) test, GaitRite Functional Ambulation Profile, 12-item Multiple Sclerosis Walking Scale (MSWS-12), and 36-item Short Form Health Status Survey (SF-36) at screening without FES; the measures were repeated with FES at baseline, 1 month, and 3 months. Results: Twenty participants (8 men and 12 women) completed this unblinded case series study. The mean age, duration of MS, and time taking dalfampridine were 51.7, 15.8, and 1.4 years, respectively. Changes from screening to baseline and screening to 3 months were analyzed. Significant improvement was noted from screening to baseline for the MSWS-12 (P = .024) and SF-36 Physical Function domain (P = .028) and from screening to 3 months for the T25FW (P = .015), MSWS-12 (P = .003), and SF-36 Physical Function (P = .032) and Role Limitation–Physical Health (P = .012) domains. Conclusions: Improvements above those induced pharmacologically suggest that FES can augment pharmacologic intervention and significantly improve gait function, decrease the impact of MS on walking, and improve quality of life for people with MS.

scholarly journals The Effectiveness of Functional Stimulation in Multiple Sclerosis (Literature Review)

2020 ◽  
Vol 99 (5) ◽  
pp. 107-119
Author(s):  
E.A. Guryanova ◽  
V.V. Kiryanova
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Clinical Studies ◽  
Functional Mobility ◽  
Medical Rehabilitation ◽  
Disease Modifying Drugs

Introduction. The restoration of motor functions in patients with multiple sclerosis is a priority task of medical rehabilitation in orderto slow the progression of the orthopedic defect and patients’ quality of life improvement. Despite the usage of disease modifying drugs, patients suffering from significant neurological disorders gain orthopedic complications. A decrease in physical activity leadsto increased body weight, trophic and other disorders, aggravating the course of the main illness and complicating the process of medical rehabilitation. Mobile functional electrical stimulation devices (FES) could became an innovative mean for the improvement of MS patient’s mobility and gait in everyday life. Aim. To provide evidence-based data from clinical studies on the potential of FES devices usage in clinical practice by patients with paresis of the lower extremities. The article deals with general characteristics of modern devices of functional electrostimulation,compares the most popular devices. The results of meta-analyzes and clinical studies on the effectiveness and safety of FES devices forthe rehabilitation of patients with multiple sclerosis are presented. The influence of functional electrical stimulation on gait parameters,ankle joint functional mobility and quality of life are considered. Conclusion. When patients with MS undergo rehabilitation using neuro-orthoses with FES, the pattern of gait is normalized, stability of walking is increased, the number of falls and the need for additional support are reduced. Among the main advantages of FES a significant increase in the mobility and independence of patients, which directly affects the quality of life is noted. FES has a positive effect on the level of physical activity and on muscle strength, cardio-respiratory parameters, as well as on a decrease in the severity of paresis. FES therapy in motion is an excellent rehabilitation tool with proved therapeutic efficacy when used in the rehabilitation of MS patients.

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

2017 ◽  
Vol 19 (3) ◽  
pp. 113-121 ◽  
Author(s):  
Deborah Backus ◽  
Blake Burdett ◽  
Laura Hawkins ◽  
Christine Manella ◽  
Kevin K. McCully ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Quality Of Life Inventory ◽  
Impact Scale ◽  
Modified Ashworth Scale ◽  
Potential Benefits ◽  
Fatigue Impact Scale

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.

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