title: Functional electrical stimulation through direct 4-channel nerve stimulation to improve gait in multiple sclerosis: a feasibility study.
abstract: BACKGROUND
  Gait dysfunction due to lower limb central paralysis, frequently involving drop foot, is a common cause of disability in multiple sclerosis and has been treated with transcutaneous functional electrical stimulation (FES). We provide here the first report of 4-channel semi-implantable FES of the peroneal nerve which has been successfully used for rehabilitation in patients following stroke.
  
  
  METHODS
  FES was implemented via a 4-channel semi-implantable closed-loop system (ActiGait(®), ©Ottobock), generating dorsiflexion in drop foot. Walking distance, gait symmetry (temporospatial gait analyses, Vicon Motion Systems(®)), gait velocity (10 m walking test) and quality of life (SF-36 questionnaire) were measured to evaluate the therapeutic benefit of this system in two patients with progressive MS.
  
  
  RESULTS
  Walking distance increased from 517 to 1884 m in Patient 1 and from 52 to 506 m in Patient 2. Gait velocity did not change significantly in Patient 1 and increased from 0.6 to 0.8 m/s in Patient 2. Maximum deviations of center of mass from the midline to each side changed significantly after 3 months of stimulation compared to baseline, decreasing from 15 to 12 mm in Patient 1 and from 47 to 37 mm in Patient 2. Both patients experienced reduced pain and fatigue and benefits to quality of life. Adverse events did not occur during the observation period.
  
  
  CONCLUSIONS
  We conclude that implantable 4-channel FES systems are not only feasible but present a promising new alternative for treating central drop foot in MS patients.
authors.affiliation: Department of Neurology, Otto-von-Guericke University, Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany. janet.hausmann@med.ovgu.de.
authors.forename: Janet
authors.initials: J
authors.lastname: Hausmann
authors.affiliation: Department of Neurology, Otto-von-Guericke University, Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany. catherine.sweeney-reed@med.ovgu.de.|Department of Stereotactic Neurosurgery, Otto-von-Guericke University, Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany. catherine.sweeney-reed@med.ovgu.de.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Sweeney-Reed
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Site Magdeburg, Leipziger Str. 44, Magdeburg, Germany. uwe.sobieray@dzne.de.
authors.forename: Uwe
authors.initials: U
authors.lastname: Sobieray
authors.affiliation: Department of Neurology, Otto-von-Guericke University, Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany. mike.matzke@med.ovgu.de.
authors.forename: Mike
authors.initials: M
authors.lastname: Matzke
authors.affiliation: Department of Neurology, Otto-von-Guericke University, Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany. hans-jochen.heinze@med.ovgu.de.
authors.forename: Hans-Jochen
authors.initials: HJ
authors.lastname: Heinze
authors.affiliation: Department of Stereotactic Neurosurgery, Otto-von-Guericke University, Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany. juergen.voges@med.ovgu.de.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Voges
authors.affiliation: Department of Stereotactic Neurosurgery, Otto-von-Guericke University, Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany. lars.buentjen@med.ovgu.de.
authors.forename: Lars
authors.initials: L
authors.lastname: Buentjen
mesh_terms: D000368:Aged; D004599:Electric Stimulation Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000150:complications / Q000534:rehabilitation*; D010543:Peroneal Nerve; D011788:Quality of Life; D016138:Walking / Q000502:physiology