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

Abstract

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.

Functional Electrical Stimulation for Foot Drop in Multiple Sclerosis

“…16 The orthotic effect was manifested in an 18.3 % improvement in performance, both at baseline and after 2 weeks of FES use, suggesting that the orthotic benefits of FES can occur prior to habituation.…”

“…5 Overall, a majority of the studies observing the effects on walking performance have reported orthotic effects, [4][5][6][7][8][9]13,14,16,20,22,24 and in some cases a total orthotic benefit after weeks of FES device use 8,24 with one study noticing this benefit only after 2 weeks. 16 Training effects have been consistently reproduced in nonprogressive neurologic conditions, such as stroke and spinal cord injury populations. This has not been the case in MS patients, and this difference has been attributed in part to the progressive course of MS. One publication, comparing stroke and MS patients, found that a training effect was present only in the stroke patient group.…”

“…8,11,13,15,16,22 In several reports, FES was perceived by pwMS as an effective device to improve walking distance and reduce the risk for falls. 12,13 Further, a reduction in the effort of walking and an increase in level of confidence during gait were reported by 18 MS patients who used FES.…”

“…The orthotic benefit, or "on-off" effect of FES on gait, has been well-documented in the MS population. [3][4][5][6][7][8][9]13,14,16,[20][21][22][23][24] More recently, the term training, or therapeutic, effect has been applied to changes in walking performance after regular, prolonged FES use when gait is evaluated without the device. 14 We will refer to this type of effect as training effect throughout this article.…”

“…Additionally, the total orthotic effect of FES (defined as the change in walking speed with FES at follow-up assessment compared with walking speed at baseline without FES 8 ) has been reported in pwMS. 8,16,24 One potential explanation for the training effect of FES is the promotion of neuroplasticity with repetitive daily stimulation, producing a cumulative effect over time. 23,25 Evereart et al 23 observed the effects of using FES Tables 1, 2, and 3.…”