A pilot study of functional electrical stimulation cycling in progressive multiple sclerosis.
BACKGROUND
Functional electrical stimulation (FES) cycling is used by spinal cord injury patients to facilitate neurologic recovery and may also be useful for progressive MS patients.


OBJECTIVE
To evaluate the safety and preliminary efficacy of home FES cycling in progressive MS and to explore how it changes cerebrospinal fluid (CSF) cytokine levels.


METHODS
Five patients with primary or secondary progressive MS were given an FES cycle for six months. Main outcome measures were: Two Minute Walk Test, Timed 25-foot Walk, Timed Up and Go Test, leg strength, Expanded Disability Status Scale (EDSS) score, and Multiple Sclerosis Functional Composite (MSFC) score. Quality-of-life was measured using the Short-Form 36 (SF-36). Cytokines and growth factors were measured in the CSF before and after FES cycling.


RESULTS
Improvements were seen in the Two Minute Walk Test, Timed 25-foot Walk, and Timed Up and Go tests. Strength improved in muscles stimulated by the FES cycle, but not in other muscles. No change was seen in the EDSS score, but the MSFC score improved. The physical and mental health subscores and the total SF-36 score improved.


CONCLUSIONS
FES cycling was reasonably well tolerated by progressive MS patients and encouraging improvements were seen in walking and quality-of-life. Larger studies of FES cycling in progressive MS are indicated.
Ratchford
John N
JN
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Shore
Wendy
W
Hammond
Edward R
ER
Rose
J Gregory
JG
Rifkin
Robert
R
Nie
Pingting
P
Tan
Kevin
K
Quigg
Megan E
ME
de Lateur
Barbara J
BJ
Kerr
Douglas A
DA
D000328:Adult; D016207:Cytokines / Q000134:cerebrospinal fluid; D004185:Disability Evaluation; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods; D005080:Exercise Test; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000134:cerebrospinal fluid; D007866:Leg / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000134:cerebrospinal fluid / Q000503:physiopathology / Q000534:rehabilitation*; D053580:Muscle Strength; D010865:Pilot Projects; D011788:Quality of Life; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking
D016207:Cytokines; D036341:Intercellular Signaling Peptides and Proteins