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.

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 Improvement in overactive bladder symptoms in patients using functional electrical stimulation of the common peroneal nerve for walking

2018 ◽  
Vol 32 (10) ◽  
pp. 1357-1362
Author(s):  
Nicola Hare ◽  
Petros Georgopoulos ◽  
Kate E Philips ◽  
Joanne E Johnson ◽  
Coralie Seary ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Overactive Bladder ◽  
Functional Electrical Stimulation ◽  
Walking Speed ◽  
Motor Neurone ◽  
Foot Drop ◽  
Overactive Bladder Symptoms ◽  
Bladder Symptoms ◽  
Multiple Sclerosis Patients

Objective: Functional electrical stimulation is used to improve walking speed and reduces falls in people with upper motor neurone foot-drop. Following anecdotal observations of changes in bladder symptoms, an observational study was performed to explore this association further. Design: A total of 47 consecutive patients attending for setup with functional electrical stimulation during a six-month period were asked to complete a questionnaire assessing bladder symptoms (ICIQ-OAB (International Consultation on Incontinence Questionnaire Overactive Bladder)) at baseline and three  months during routine appointments. Subjects: In all, 35 (75%) had multiple sclerosis and the other 12 subjects had a total of 9 diagnoses including 3 with stroke. Other conditions included cerebral palsy, motor neurone disease, hereditary spastic paraparesis, meningioma and spinocerebellar ataxias. Results: Improvement in overactive bladder symptoms was not significant in the whole cohort, however, was significant in patients with multiple sclerosis ( n  =  35; mean change in ICIQ-OAB score 1.0, P  =  0.043). Specifically, significant improvements were seen in urgency and urge incontinence in multiple sclerosis patients. There was a significant negative correlation of moderate strength within the multiple sclerosis cohort between baseline walking speed and subsequent change in ICIQ-OAB score (correlation coefficient of r  =  −0.40, P  =  0.046). Thus, greater changes in bladder symptoms were seen with lower baseline walking speeds. Conclusion: The results of this exploratory study suggest that functional electrical stimulation use does improve overactive bladder symptoms in people with multiple sclerosis. Further exploration is needed to study this association and explore whether the mechanism is similar to that of percutaneous tibial nerve stimulation, a recognized treatment for the overactive bladder.

Does Functional Electrical Stimulation for Foot Drop Strengthen Corticospinal Connections?

2009 ◽  
Vol 24 (2) ◽  
pp. 168-177 ◽  
Author(s):  
Dirk G. Everaert ◽  
Aiko K. Thompson ◽  
Su Ling Chong ◽  
Richard B. Stein
Keyword(s):  
Electrical Stimulation ◽  
Therapeutic Effect ◽  
Functional Electrical Stimulation ◽  
Peroneal Nerve ◽  
Walking Speed ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Walking Performance ◽  
The Common

Background. Long-term use of a foot-drop stimulator applying functional electrical stimulation (FES) to the common peroneal nerve improves walking performance even when the stimulator is off. This “therapeutic” effect might result from neuroplastic changes. Objective. To determine the effect of long-term use of a foot-drop stimulator on residual corticospinal connections in people with central nervous system disorders. Methods. Ten people with nonprogressive disorders (eg, stroke) and 26 with progressive disorders (eg, multiple sclerosis) used a foot-drop stimulator for 3 to 12 months while walking in the community. Walking performance and electrophysiological variables were measured before and after FES use. From the surface electromyogram of the tibialis anterior muscle, we measured the following: (1) motor-evoked potential (MEP) from transcranial magnetic stimulation over the motor cortex, (2) maximum voluntary contraction (MVC), and (3) maximum motor wave (Mmax) from stimulating the common peroneal nerve. Results. After using FES, MEP and MVC increased significantly by comparable amounts, 50% and 48%, respectively, in the nonprogressive group and 27% and 17% in the progressive group; the changes were positively correlated ( R2 = .35; P < .001). Walking speed increased with the stimulator off (therapeutic effect) by 24% ( P = .008) and 7% ( P = .014) in the nonprogressive and progressive groups, respectively. The changes in Mmax were small and not correlated with changes in MEP. Conclusions. The large increases in MVC and MEP suggest that regular use of a foot-drop stimulator strengthens activation of motor cortical areas and their residual descending connections, which may explain the therapeutic effect on walking speed.

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 An exploration of the experiences and utility of functional electrical stimulation for foot drop in people with multiple sclerosis

2018 ◽  
Vol 42 (4) ◽  
pp. 510-518
Author(s):  
Linda (Miller) Renfrew ◽  
Paul Flowers ◽  
Anna C. Lord ◽  
Danny Rafferty ◽  
Angus K. McFadyen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Foot Drop

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 THERAPEUTIC EFFECTS OF ANKLE JOINT TAPING COMBINED WITH FUNCTIONAL ELECTRICAL STIMULATION FOR THE CORRECTION OF POST STROKE FOOT DROP

2015 ◽  
Vol 4 (2) ◽  
pp. 15-20
Author(s):  
Amna Aamir Khan ◽  
Hassan Abbas ◽  
Rabbia Naseer Ahmed ◽  
Maria Salman
Keyword(s):  
Electrical Stimulation ◽  
Ankle Joint ◽  
Functional Electrical Stimulation ◽  
Ankle Dorsiflexion ◽  
Foot Drop ◽  
Manual Muscle Testing ◽  
Therapeutic Effects ◽  
Post Stroke ◽  
Muscle Testing ◽  
Significant Difference

OBJECTIVE Post stroke foot is inability to lift foot at ankle joint due to paralysis of ankle dorsiflexor muscles. It is a common problem faced by stroke survivors. To determine the effect of ankle joint taping combined with functional electrical stimulation on post stroke foot drop. METHODS It was an experimental study. 10 stroke patients with foot drop were enlisted for the study by convenience sampling and randomized into two groups. The group A or treatment group (n-5) received kinesiotaping of ankle joint and functional electrical stimulation while group B or control group (n-5) received functional electrical stimulation only. Clinical assessment was done before and after study. Outcome measures were Manual Muscle Testing, active ankle dorsiflexion and time up and go test. RESULTS Improvement was recorded in both kinesiotaping of ankle joint with functional electrical stimulation and functional electrical stimulation groups for MMT and active range of ankle dorsiflexion and there was no significant improvement in time up and go test. But statistically non-significant difference between both groups is observed (Z=-2.000, p=0.46). CONCLUSIONS These results indicate that there is no clear benefit of ankle joint taping combined with functional electrical stimulation for correction of post stroke foot drop. Keywords: Foot Drop, Functional Electrical Stimulation, Ankle Joint Taping, Kinesiotaping, Dorsiflexion, Manual Muscle Testing

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