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

Street, Tamsyn; Singleton, Christine

doi:10.7224/1537-2073.2016-094

Cited by 10 publications

(18 citation statements)

References 12 publications

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“…An observational study that investigated the effect of FES on a range of measures over 5 years in a large cohort of participants with MS (n = 145) reported a statistically significant positive orthotic effect of FES on walking speed and joint pain, but there was no effect on QOL as measured by a self-reported visual analogue scale. 42 Future studies should consider investigating the effect of FES using a valid, clinically meaningful HRQOL over longer periods. Such studies, however, are challenging to undertake due to the potentially high dropout rate experienced in assistive device trials of longer duration.…”

Section: Discussionmentioning

confidence: 99%

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

Renfrew¹,

Lord²,

Warren³

et al. 2019

International Journal of MS Care

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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.

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Section: Discussionmentioning

confidence: 99%

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

Renfrew¹,

Lord²,

Warren³

et al. 2019

International Journal of MS Care

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“…The authors concluded that the foot drop itself was more important than the diagnosis and pointed out that disease progression itself may account for the slightly different courses over the longer term. We note, moreover, that at 5 year follow-up, patients with MS continued to have an orthotic effect with tcFES [26].…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of semi-implantable functional electrical stimulation for central drop foot

Buentjen

Kupsch

Galazky

et al. 2019

J NeuroEngineering Rehabil

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Background Central drop foot is a common problem in patients with stroke or multiple sclerosis (MS). For decades, it has been treated with orthotic devices, keeping the ankle in a fixed position. It has been shown recently that semi-implantable functional electrical stimulation (siFES) of the peroneal nerve can lead to a greater gait velocity increase than orthotic devices immediately after being switched on. Little is known, however, about long-term outcomes over 12 months, and the relationship between quality of life (QoL) and gait speed using siFES has never been reported applying a validated tool. We provide here a report of short (3 months) and long-term (12 months) outcomes for gait speed and QoL. Methods Forty-five consecutive patients (91% chronic stroke, 9% MS) with central drop foot received siFES (Actigait®). A 10 m walking test was carried out on day 1 of stimulation (T1), in stimulation ON and OFF conditions, and repeated after 3 (T2) and 12 (T3) months. A 36-item Short Form questionnaire was applied at all three time points. Results We found a main effect of stimulation on both maximum ( p < 0.001) and comfortable gait velocity (p < 0.001) and a main effect of time ( p = 0.015) only on maximum gait velocity. There were no significant interactions. Mean maximum gait velocity across the three assessment time points was 0.13 m/s greater with stimulation ON than OFF, and mean comfortable gait velocity was 0.083 m/s faster with stimulation ON than OFF. The increase in maximum gait velocity over time was 0.096 m/s, with post hoc testing revealing a significant increase from T1 to T2 ( p = 0.012 ) , which was maintained but not significantly further increased at T3. QoL scores showed a main effect of time ( p < 0.001), with post hoc testing revealing an increase from T1 to T2 (p < 0.001), which was maintained at T3 (p < 0.001). Finally, overall absolute QoL scores correlated with the absolute maximum and comfortable gait speeds at T2 and T3, and the increase in overall QoL scores correlated with the increase in comfortable gait velocity from T1 to T3. Pain was reduced at T2 (p < 0.001) and was independent of gait speed but correlated with overall QoL (p < 0.001). Conclusions Peroneal siFES increased maximal and comfortable gait velocity and QoL, with the greatest increase in both over the first three months, which was maintained at one year, suggesting that 3 months is an adequate follow-up time. Pain after 3 months correlated with QoL and was independent of gait velocity, suggesting pain as an independent outcome measure in siFES for drop foot.

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“…Walking speed is increased similar to use of an ankle foot orthosis; however, little is known about the cost-effectiveness of functional electrical stimulation. 1–5…”

Section: Introductionmentioning

confidence: 99%

“…Walking speed is increased similar to use of an ankle foot orthosis; however, little is known about the cost-effectiveness of functional electrical stimulation. [1][2][3][4][5] Increase in walking speed is most often reported to reflect clinical efficacy and in fact walking speed has previously been used as a surrogate marker of quality of life in determining cost-effectiveness of functional electrical stimulation; 6 however, other effects such as increase in confidence, reduced falls or less effort of walking may all contribute to increased participation and are equally important. 7 Investigators have looked at the effect of functional electrical stimulation on the Psychosocial Impact of Assistive Device Scale, a measure of the impact of an assisted device on the user's self-esteem, adaptability (impact on participation) and competence (aspects of walking).…”

Section: Introductionmentioning

confidence: 99%

A cohort study of functional electrical stimulation in people with multiple sclerosis demonstrating improvements in quality of life and cost-effectiveness

Juckes

Marceniuk²,

Seary

et al. 2019

Clin Rehabil

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Objective: The objective of this study was to determine the impact on health-related quality of life of functional electrical stimulation used to improve walking in people with multiple sclerosis and to explore cost-effectiveness. Design: A retrospective analysis of patient records was conducted. Setting: This study used outpatient therapy service as the study setting. Subjects: Data from 82 consecutive patients with multiple sclerosis attending for set up with functional electrical stimulation were analysed. Interventions: Patients were seen at baseline, three and six months for support in use of functional electrical stimulation, and data were collected at baseline and six months. Main measures: The EQ-5D-5L and walking speed were collected at baseline and six months after using functional electrical stimulation. The Psychosocial Impact of Assistive Device Scale was collected at six months. EQ-5D-3L utilities were derived and cost-effectiveness analysis was completed utilizing a five-year time horizon and methodology published by National Institute for Health and Care Excellence. Results: Significant differences (P < 0.001) were seen in walking speed (baseline 0.670 m/s; with stimulation 0.768 m/s) and maintained over six months (0.772 m/s with stimulation). EQ-5D data significantly improved over six months (baseline 0.486, six months 0.596, P < 0.001) and meaningful mean scores were seen in all aspects of the Psychosocial Impact of Assistive Device Scale. However, there were no correlations between measures. In the cost utility analysis, compared to standard care, functional electrical stimulation was more expensive and more effective with an incremental cost-effectiveness ratio of £6137. Conclusion: Functional electrical stimulation is a cost-effective treatment to improve walking speed and health-related quality of life in people with multiple sclerosis.

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

Cited by 10 publications

References 12 publications

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

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

Long-term outcomes of semi-implantable functional electrical stimulation for central drop foot

A cohort study of functional electrical stimulation in people with multiple sclerosis demonstrating improvements in quality of life and cost-effectiveness

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