Doctor of Philosophy (PhD) in Physical Therapy
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College of Health Care Sciences - Physical Therapy Department
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Nova Southeastern University
Lori Hochman. 2018. Effects of Functional Electrical Stimulation Cycling versus Cycling Only on Walking Performance and Quality of Life in Individuals with Multiple Sclerosis: A Randomized, Clinical Pilot Study. Doctoral dissertation. Nova Southeastern University. Retrieved from NSUWorks, College of Health Care Sciences - Physical Therapy Department. (75)
Background: Functional Electrical Stimulation (FES) stimulates peripheral nerves via electrical current to evoke muscle contractions and when combined with lower extremity cycling (LE), creates patterned leg movements. Previous studies demonstrated FES cycling is safe and effective in the spinal cord injury and stroke populations with improvements seen in walking speed, muscle mass, and bone density. Few studies have applied FES cycling to a neurodegenerative disorder, such as multiple sclerosis (MS). The aim of this study is to assess the effect of an 8-week training program using FES cycling, compared to Cycling Only, in people with MS (PWMS). Methods: Using a sample of convenience, PWMS were recruited to participate and randomized to the FES Cycling group or the Cycling Only group. Both groups received training three-times per week for 8- weeks using a LE ergometer. Scores on the 6 Minute Walk Test (6MWT), Times 25-Foot Walk Test (T25FW), Five Times Sit-to-Stand (5XSST), and Timed Up and Go (TUG), and spatiotemporal measure of gait were collected at baseline, (before the 1st session), 4-weeks (before the 13th session), 8-weeks (after the 24th training session), and at 4-week follow-up. Scores on the MS Quality of Life-54 (MSQOL), Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale-12 (MSWS-12), and Activities-specific Balance Confidence Scale (ABC) were collected at baseline, 8-weeks, and at 4-week follow-up. Results: Fourteen participants (8 female, 6 male, mean age = 53.64 ± 10.16 years; Patient Determined Disease Steps (PDDS) mean = 3.71 ± .091) completed the training. Cycling power output significantly increased in both groups over time (FES Cycling, p = 0.03; Cycling only p = 0.004), but no differences were found between groups (p = 0.08). The Cycling Only group demonstrated a slightly larger effect size for power output than the FES Group (d = 0.72 vs. 0.66). Immediately after the intervention period, scores on the 6MWT, 5XSST, and MFIS, and subscores of the MSQOL-54 improved significantly, but changes did not consistently favor one group over the other (p >0.05). There were no significant differences between groups on any of the outcome measures. Conclusions: FES Cycling or Cycling Only may be an effective intervention for improving walking endurance, sit-to-stand, and QOL in PWMS. This unique pilot study compared FES cycling versus Cycling Only for PWMS using a customized progression protocol. Further research with larger sample sizes are needed to better understand the effects of FES Cycling on PWMS.
Health and environmental sciences, Cycling, Exercise, Functional electrical stimulation, Gait, Multiple sclerosis, Quality of life