Functional electrical stimulation-assisted cycling of patients with multiple sclerosis: biomechanical and functional outcome--a pilot study.

Abstract

To determine whether functional electrical stimulation-supported ergometric training of patients with multiple sclerosis has a prosthetic or therapeutic effect on biomechanical (power, smoothness of cycling) and functional outcomes (walking capability, strength of muscle, spasticity). Twelve subjects with multiple sclerosis participated in an electrical stimulation-supported ergometric training (3 sessions/week for 2 weeks). Measurements were made in a cross-over design to study prosthetic (with and without stimulation) and therapeutic effects (before and after training). Power and smoothness were calculated by cadence and torque recordings of cycling and spasticity; strength and walking capability were measured by the Modified Ashworth Scale, Manual Muscle Test, and 10-Metre Walk Test. The power and smoothness of pedalling significantly improved prosthetically with electrical stimulation (p=0.02), but did not show significant improvement over the 2 weeks of training. Significant short-term reductions in spasticity (before vs after training session; p<0.05) were found. Isometric strength did not increase significantly during the 2-week training period and there was no improvement in walking ability. Patients with multiple sclerosis are able to improve their cycling power and smoothness by pedalling with stimulation. We suggest that severely affected patients benefit more from functional electric stimulation-cycling therapy than do slightly affected patients.