Habitual functional electrical stimulation therapy improves gait kinematics and walking performance, but not patient-reported functional outcomes, of people with multiple sclerosis who present with foot-drop

People with Multiple Sclerosis (pwMS) often experience a disturbed gait function such as foot-drop. The objective of this pilot study was to investigate the medium term effects of using Functional Electrical Stimulation (FES) to treat foot-drop over a period 12 weeks on gait and patient reported out...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2014-08, Vol.9 (8), p.e103368-e103368
Main Authors: van der Linden, Marietta L, Hooper, Julie E, Cowan, Paula, Weller, Belinda B, Mercer, Thomas H
Format: Article
Language:English
Subjects:
Adult
Ankle
Biomechanical Phenomena
Change detection
Contact angle
Electric contacts
Electric Stimulation Therapy
Electrical stimuli
Ethics
Exercise
Fatigue
Feet
Female
Females
Gait
Health services
Humans
Kinematics
Male
Males
Medicine and Health Sciences
Middle Aged
Multiple sclerosis
Multiple Sclerosis - physiopathology
Multiple Sclerosis - therapy
Patient outcomes
Physical fitness
Pilot Projects
Posture
Psychomotor Performance
R&D
Research & development
Self Report
Statistical analysis
Stimulation
Stroke
Studies
Training
Treatment Outcome
Walking
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:People with Multiple Sclerosis (pwMS) often experience a disturbed gait function such as foot-drop. The objective of this pilot study was to investigate the medium term effects of using Functional Electrical Stimulation (FES) to treat foot-drop over a period 12 weeks on gait and patient reported outcomes of pwMS. Nine pwMS aged 35 to 64 (2 males, 7 females) were assessed on four occasions; four weeks before baseline, at baseline and after six weeks and twelve weeks of FES use. Joint kinematics and performance on the 10 meter and 2 minute walk tests (10WT, 2 minWT) were assessed with and without FES. Participants also completed the MS walking Scale (MSWS), MS impact scale (MSIS29), Fatigue Severity Score (FSS) and wore an activity monitor for seven days after each assessment. Compared to unassisted walking, FES resulted in statistically significant improvements in peak dorsiflexion in swing (p = 0.006), 10MWT (p = 0.006) and 2 minWT (p = 0.002). Effect sizes for the training effect, defined as the change from unassisted walking at baseline to that at 12 weeks, indicated improved ankle angle at initial contact (2.6°, 95% CI -1° to 4°, d = 0.78), and a decrease in perceived exertion over the 2 min walking tests (-1.2 points, 95% CI -5.7 to 3.4, d = -0.86). Five participants exceeded the Minimally Detectable Change (MDC) for a training effect on the 10mWT, but only two did so for the 2 minWT. No effects of the use of FES for 12 weeks were found for MSWS, MSIS29, FSS or step count. Although FES to treat foot-drop appears to offer the potential for a medium term training effect on ankle kinematics and walking speed, this was not reflected in the patient reported outcomes. This observed lack of relationship between objective walking performance and patient reported outcomes warrants further investigation. ClinicalTrials.gov NCT01977287.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0103368