Downing Abbey, Van Ryn David, Fecko Anne, Aiken Christopher, McGowan Sean, Sawers Sarah, McInerny Thomas, Moore Katie, Passariello Louis, Rogers Helen
Hanger Prosthetics and Orthotic Clinic, Torrington, CT, USA (AD); Wethersfield, CT, USA (DVR); Woburn, MA, USA (AF); Somersworth, NH, USA (CA); Greenville, NC, USA (SM); Seattle, WA, USA (SS); Albany, NY, USA (TM); Columbia, SC, USA (KM); and New London, CT, USA (LP); and Innovative Neurotronics, Galveston, TX, USA (HR).
Int J MS Care. 2014 Fall;16(3):146-52. doi: 10.7224/1537-2073.2013-032.
Footdrop is a common gait deviation in people with multiple sclerosis (MS) leading to impaired gait and balance as well as decreased functional mobility. Functional electrical stimulation (FES) provides an alternative to the current standard of care for footdrop, an ankle-foot orthosis (AFO). FES stimulates the peroneal nerve and activates the dorsiflexor muscles, producing an active toe clearance and a more normal gait. This study was undertaken to determine the effects of a 2-week FES Home Assessment Program on gait speed, perceived walking ability, and quality of life (QOL) among people with MS-related footdrop.
Participants completed the Timed 25-Foot Walk test (T25FW) and two self-report measures: 12-item Multiple Sclerosis Walking Scale (MSWS-12) and 29-item Multiple Sclerosis Impact Scale (MSIS-29). Measures were taken without FES before and with FES after 2 weeks of full-time FES wear.
A total of 19 participants (10 female, 9 male) completed the study; mean age and duration of disease were 51.77 ± 10.16 and 9.01 ± 7.90 years, respectively. Use of FES for 2 weeks resulted in a significant decrease in time to complete the T25FW (P < .0001), the MSWS-12 standardized score (P < .0001), and the MSIS-29 total (P < .0001), Physical subscale (P < .0001), and Psychological subscale (P = .0006) scores.
These results suggest that use of FES can significantly improve gait speed, decrease the impact of MS on walking ability, and improve QOL in people with MS-related footdrop even over a short period of time.
足下垂是多发性硬化症(MS)患者常见的步态偏差,会导致步态和平衡受损以及功能活动能力下降。功能性电刺激(FES)为目前足下垂的标准治疗方法——踝足矫形器(AFO)提供了一种替代方案。FES刺激腓总神经并激活背屈肌,产生主动的足趾离地间隙和更正常的步态。本研究旨在确定为期2周的FES家庭评估计划对MS相关足下垂患者的步态速度、自我感知步行能力和生活质量(QOL)的影响。
参与者完成了25英尺定时步行测试(T25FW)以及两项自我报告测量:12项多发性硬化症步行量表(MSWS-12)和29项多发性硬化症影响量表(MSIS-29)。在完全佩戴FES之前和佩戴2周FES之后进行测量。
共有19名参与者(10名女性,9名男性)完成了研究;平均年龄和病程分别为51.77±10.16岁和9.01±7.90年。使用FES 2周导致完成T25FW的时间显著减少(P<.0001),MSWS-12标准化分数(P<.0001),以及MSIS-29总分(P<.0001)、身体亚量表(P<.0001)和心理亚量表(P=.0006)分数显著降低。
这些结果表明,即使在短时间内,使用FES也可以显著提高MS相关足下垂患者的步态速度,降低MS对步行能力的影响,并改善其生活质量。