A pilot study of functional electrical stimulation cycling in progressive multiple sclerosis

Article type: Research Article

Authors: Ratchford, John N.^a | Shore, Wendy^b | Hammond, Edward R.^a | Rose, J. Gregory^b | Rifkin, Robert^a | Nie, Pingting^a | Tan, Kevin^{a; d} | Quigg, Megan E.^{a; e} | de Lateur, Barbara J.^a | Kerr, Douglas A.^{a; c; f; *}

Affiliations: [a] Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA | [b] Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA | [c] Department of Molecular Microbiology and Immunology, Johns Hopkins University School of Medicine, Baltimore, MD, USA | [d] Department of Neurology, National Neuroscience Institute, Singapore | [e] Department of Neurology, University of Texas, Southwestern, Dallas, TX, USA | [f] Biogen-IDEC, Cambridge, MA, USA

Correspondence: [*] Address for correspondence: Douglas A. Kerr, MD, PhD, Biogen-IDEC, 14 Cambridge Center, Building 6, Office S16, Cambridge, MA 02142, USA. Tel.: +1 617 679 2788; Fax: +1 617 679 2726; E-mail: Doug.kerr@biogenidec.com

Abstract: 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.

Keywords: Multiple sclerosis, electric stimulation, rehabilitation, cerebrospinal fluid, physical therapy modalities

DOI: 10.3233/NRE-2010-0588

Journal: NeuroRehabilitation, vol. 27, no. 2, pp. 121-128, 2010