Functional Electrical Stimulation (FES) Reduces Intermittent Claudication (IC) and Improves Quality of Life (QOL) Measures: A Cohort Crossover

Abstract

Aim: This crossover investigation applied functional electrical stimulation (FES) to the dorsiflexors (DF) and plantarflexors (PF) during walking in the home environment, hypothesizing that it will reduce intermittent claudication (IC), improve walking distance, and enhance quality of life measures compared to three baseline data points during which FES was not provided. Methods:Nine male patients, 68.4±4 yrs old, and ankle-brachial index between 0.4-0.8 who completed 16 weeks walking 1hr, 6 days/week without FES consented to walk the same amount wearing FES applied bilaterally to the DF and PF. Measurements of perceived pain intensity (PPI) at the end of a 6min walk test (6MW), walking distance, peripheral arterial disease quality of life (PADQOL), intermittent claudication questionnaire (ICQ) and timed up and go (TUG) were obtained at baseline (T0), after 8 weeks walking without FES (T1), after 8 weeks follow up (T2) and after 8 weeks walking with FES (T3). Repeated ANOVA was used to analyze the data and significance was assessed at the P<.05 level.Results: PPI at T0 was 51.3±19.4 and significantly dropped to 9.9±11.1 (p<.001) at T3 registering a large effect size (Ƞ2=.42), PADQOL factor 3 improved by 14.8 points between T0 and T3 (p=.01; Ƞ2=.36) and ICQ score improved by 16.3 points (p=.004; Ƞ2=.36). The 6MW distance and TUG did not change during the study. Conclusion:This crossover study added validity to the hypothesis that applying FES while walking can markedly diminish the intermittent claudication pain and improve quality of life measures in community ambulatory patients with PAD and IC.