Functional Electrical Stimulation
Esnouf JE, Taylor PN, Mann GE, et al. Impact on activities of daily living using a functional electrical stimulation device to improve dropped foot in people with multiple sclerosis, measured by the Canadian Occupational Performance Measure. Mult Scler 2010; 16(9):1141-7.
Aimed at determining if the Odstock dropped foot stimulator (ODFS), improved activities of daily living for people with multiple sclerosis. The study showed that people with multiple sclerosis using the ODFS increased their COPM performance and satisfaction scores of their identified problems of activities of daily living; more than a matched group who received physiotherapy exercises. ODFS users also experienced fewer falls.
Ratchford JN, Shore W, Hammond ER, et al. A pilot study of functional electrical stimulation cycling in progressive multiple sclerosis. NeuroRehabilitation 2010; 27(2):121-8.
Evaluated the safety and preliminary efficacy of home FES cycling in five patients with primary or secondary progressive MS and explored how it changed cerebrospinal fluid (CSF) cytokine levels over for six months. It was concluded that FES cycling was reasonably well tolerated by progressive MS patients and encouraging improvements were seen in walking and quality-of-life.
Szecsi J, Schlick C, Schiller M, et al. Functional electrical stimulation-assisted cycling of patients with multiple sclerosis: Biomechanical and functional outcome - A pilot study. J Rehabil Med 2009; 41(8): 674-680.
Investigates 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). Concludes that people with MS are able to improve their cycling power and smoothness by pedalling with stimulation.
National Institute for Health and Clinical Excellence. IPG278 Functional electrical stimulation for drop foot of central neurological origin: public information. [Cited 21 September 2009]. Available from: URL: http://guidance.nice.org.uk/IPG278 X
In January 2009, the National Institute for Health and Clinical Excellence issued guidance that FES can be "offered routinely as a treatment option for people with drop foot caused by damage to the brain or spinal cord" if the doctor feels it is appropriate
Barrett CL, Mann GE, Taylor PN, et al. A randomized trial to investigate the effects of functional electrical stimulation and therapeutic exercise on walking performance for people with multiple sclerosis. Mult Scler 2009; 15 (4): 493-504.
44 patients were randomized to receive FES or a physiotherapy home exercise program for a period of 18 weeks. The exercise group showed a statistically significant increase in 10m walking speed and distance walked in 3 min, relative to the FES group who showed no significant change in walking performance without stimulation. At each stage of the trial, the FES group performed to a significantly higher level with FES than without for the same outcome measures. Authors conclude that more research is required to investigate the combined therapeutic effects of FES and exercise for this patient group.
Paul L, Rafferty D, Young S, et al. The effect of functional electrical stimulation on the physiological cost of gait in people with multiple sclerosis. Mult Scler 2008; 14 (7): 954-961
Study investigated the effect of FES, in terms of speed and physiological cost of gait, in people with multiple sclerosis. Twelve people with MS and 12 healthy matched controls walked at their own preferred walking speed for 5 minutes around a 10m elliptical course. Subjects with MS completed the protocol with and without using their FES. Wearing FES lead to a significant improvement in walking and a significant reduction in the physiological cost of gait.
Taylor PN, Burridge JH, Dunkerley AL, Wood DE, Norton JA, Singleton C, Swain ID. Clinical use of the Odstock dropped foot stimulator: its effect on the speed and effort of walking. Arch Phys Med Rehabil 1999; 80(12):1577-83.
Retrospective study of 151 patients over 4 months who had used an FES device and had an upper motor neuron lesion. 21 patients with MS experienced increase in walking speed and reduction in physiological exertion whilst moving when wearing the device, but, unlike stroke patients, there was no ‘carry-over’ to normal walking when not wearing the device.
Burridge J, Taylor P, Hagan S, Swain I. Experience of clinical use of the Odstock dropped foot stimulator. Artif Organs 1997;21(3): 254-60.
Initial data on 56 patients, including 5 with MS, showing that the FES device increased walking speed, decreased effort of walking and improved functional mobility.