Functional electrical stimulation as a component of activity-based restorative therapy may preserve function in persons with multiple sclerosis

Objective: To examine the effect of functional electrical stimulation (FES) cycling on disability progression in persons with multiple sclerosis (MS). Design: Retrospective cohort, 40 participants with mean follow-up of 15 months. Setting: International Center for Spinal Cord Injury at Kennedy Krieger Institute in Baltimore, a rehabilitation referral center. Participants: Forty consecutive persons with MS undergoing rehabilitation from 2007 to 2011, with at least two evaluations based on the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Interventions: FES cycling as part of activity-based restorative therapy interventions. Outcome measures: Change in Expanded Disability Status Scale (EDSS) and ISNCSCI motor, light touch, and pin prick scores from baseline to latest evaluation. Results: In 71% of patients, activity-based rehabilitation included FES cycling. There was no disability progression on the EDSS. Lower extremity motor scores improved or stabilized in 75% of patients with primary progressive MS (PPMS), 71.4% with secondary progressive MS (SPMS), and 54.5% with relapsing remitting MS (RRMS). Among patients with improved or stabilized lower extremity motor function, PPMS recorded a mean 9% improvement, SPMS 3% and RRMS 6%. In PPMS, use of FES showed trend towards improvement in motor scores (P = 0.070). Conclusions: FES as part of activity-based rehabilitation may help preserve or improve neurological function in patients with MS.