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


METHODS
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).


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Szecsi
Johann
J
Center for Sensorimotor Research, Department of Neurology, Ludwig-Maximillians University, Munich, Germany. jszecsi@nefo.med.uni-muenchen.de
Schlick
Cornelia
C
Schiller
Martin
M
Pöllmann
Walter
W
Koenig
Nikolaus
N
Straube
Andreas
A
D000328:Adult; D001642:Bicycling; D001696:Biomechanical Phenomena; D018592:Cross-Over Studies; D004599:Electric Stimulation Therapy; D016552:Ergometry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000534:rehabilitation*; D009128:Muscle Spasticity / Q000503:physiopathology / Q000534:rehabilitation; D053580:Muscle Strength / Q000502:physiology; D010865:Pilot Projects; D016896:Treatment Outcome