Functional cycling ergometry with or without electrical stimulation in individuals with secondary progressive multiple sclerosis: A randomized controlled trial.

BACKGROUND

People with secondary progressive multiple sclerosis (PwSPMS) experience symptoms impacting their ability to walk or exercise. Functional electrical stimulation (FES) cycling is a promising, safe therapeutic intervention for MS, but relatively little is known about its use in PwSPMS with moderate to severe disability.

OBJECTIVE

To determine effects of active FES and passive cycling on walking speed and other disability measures in PwSPMS.

METHODS

PwSPMS and Expanded Disability Status Scale (EDSS) 5.0-7.0 were randomized to a 12-week FES-assisted or passive (control) cycling intervention. The primary outcome was change in Timed 25-Foot Walk (T25FW [s]) pre-post intervention. Secondary outcomes assessed functional mobility (Timed Up and Go [TUG], 2-Minute Walk Test), strength, disability, cognition and quality of life.

RESULTS

Fourteen participants completed the intervention (8 active FES; 6 passive). One active FES cyclist with an unrelated injury was excluded from analysis. Mean ±SD age was 54.1 ± 8.9 years and 85 % were female. Participants tolerated the intervention. No significant differences were observed between participants receiving FES compared to passive cycling in any measures. Within groups, FES cyclists trended towards but did not reach significant improvement in T25FW (10.2 to 8.4 s; p = 0.08), while passive cyclists significantly improved in TUG (12.4 to 11.6 s; p = 0.03).

CONCLUSION

Change in ambulatory function did not differ in participants receiving FES versus passive cycling. Within-group improvement occurred in isolated measures and no adverse events occurred, demonstrating feasibility and acceptability. Longer interventions may be necessary to demonstrate improvements beyond lack of decline, given greater baseline disability in this population.