Department of Clinical Science and Engineering, Salisbury District Hospital, Salisbury, UK.
Neuromodulation. 2014 Jan;17(1):75-84; discussion 84. doi: 10.1111/ner.12048. Epub 2013 Apr 19.
To examine the effect of Functional Electrical Stimulation (FES) for dropped foot and hip instability in combination with physiotherapy core stability exercises.
Twenty-eight people with secondary progressive multiple sclerosis and unilateral dropped foot participated in a randomized crossover trial. Group1 received FES for correction of dropped foot for six weeks with the addition of hip extension for a further six weeks. In weeks 12-18, FES was continued with the addition of eight sessions of core stability physiotherapy with home-based exercise. FES and home-based exercise were continued until weeks 19-24. Group 2 received the same physiotherapy intervention over the first 12 weeks, adding FES in the second 12 weeks.
FES improved walking speed and Rivermead Observational Gait Analysis (ROGA) score, whereas physiotherapy did not. Adding gluteal stimulation further improved ROGA score. Both interventions reduced falls, but adding FES to physiotherapy reduced them further. FES had greater impact on Multiple Sclerosis Impact Scale, MSIS-29.
The intervention was feasible. FES for dropped foot may improve mobility and quality of life and may reduce falls. Adding gluteal stimulation further improved gait quality. Adding physiotherapy may have enhanced the effect of FES, but FES had the dominant effect.
研究功能性电刺激（FES）联合物理疗法核心稳定性训练对足下垂和髋关节不稳定的影响。
28 名继发性进行性多发性硬化症单侧足下垂患者参与了一项随机交叉试验。第 1 组接受 FES 治疗 6 周以纠正足下垂，随后再接受 6 周的髋关节伸展治疗。第 12-18 周，FES 治疗继续，并增加 8 次核心稳定性物理治疗和家庭锻炼。FES 和家庭锻炼一直持续到第 19-24 周。第 2 组在前 12 周接受相同的物理治疗干预，在第 12-24 周增加 FES。
FES 提高了行走速度和 Rivermead 观察步态分析（ROGA）评分，而物理治疗则没有。增加臀肌刺激进一步提高了 ROGA 评分。两种干预都减少了跌倒，但 FES 联合物理治疗进一步减少了跌倒。FES 对多发性硬化症影响量表（MSIS-29）的影响更大。
该干预措施是可行的。FES 治疗足下垂可能会提高移动能力和生活质量，并减少跌倒。增加臀肌刺激进一步改善了步态质量。增加物理治疗可能增强了 FES 的效果，但 FES 具有主导作用。
