Institute for Clinical Exercise and Health Science, School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire, Scotland.
Institute for Clinical Exercise and Health Science, School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire, Scotland.
Mult Scler Relat Disord. 2020 Jan;37:101485. doi: 10.1016/j.msard.2019.101485. Epub 2019 Oct 31.
People with Multiple Sclerosis (PwMS) are at an increased risk of diseases associated with low levels of physical activity (PA). Deconditioning may lead to an acceleration in the development of secondary complications from MS, impairing physical function and exacerbating disease progression. Functional Electrical Stimulation (FES) Cycling may provide a suitable lower limb exercise intervention for PwMS with mobility impairment. The effects of FES cycling on cardiovascular, musculoskeletal and functional outcomes for PwMS with mobility impairment are yet to be investigated to date.
The objective of this review was to systematically examine the outcomes of PwMS with mobility impairment following FES cycling intervention.
A systematic search of four electronic databases (MEDLINE, Web of Science, CINAHL and PEDro) from their inception to 8th January 2019 was performed. Inclusion criteria was (1) include human participants with definite diagnosis of MS (2) participants had to be aged 18 years or older (3) include participants with mobility impairment (determined as an average participant EDSS ≥ 6.0) (4) evaluate FES cycling as an intervention study.
Initial searches found 1163 studies. 9 of which met the full inclusion criteria: 5 pre-post studies with no control group, 2 randomised controlled trials (RCTs), 1 retrospective study and 1 case study. Two studies had the same participant group and intervention but reported different outcomes. Outcome data was available for n = =76 unique participants, with n = =82 completing a FES cycling intervention. Of the n = =4 papers with clear dropout rates, pooled dropout rate was 25.81%. Two papers reported non-significant improvements in aerobic capacity following a FES cycling intervention. Four papers reported no change in lower limb strength and two papers reported significant reductions in spasticity post training. Four studies failed to provide information regarding adverse events with the other studies reporting n = =10 adverse events across 36 participants.
Findings suggest FES cycle training may reduce CVD risk alongside trends for a reduction in spasticity post training, however the low quality of the literature precludes any definitive conclusions. FES cycle training appears to be well tolerated in PwMS with mobility impairment, with no serious adverse events.
多发性硬化症（MS）患者发生与低体力活动（PA）相关疾病的风险增加。失健可能导致 MS 的继发性并发症加速发展，从而损害身体功能并加剧疾病进展。功能性电刺激（FES）自行车可能为有运动障碍的 MS 患者提供合适的下肢运动干预。迄今为止，还没有研究 FES 自行车运动对有运动障碍的 MS 患者的心血管、肌肉骨骼和功能结果的影响。
本综述的目的是系统地检查有运动障碍的 MS 患者在接受 FES 自行车运动干预后的结果。
从四个电子数据库（MEDLINE、Web of Science、CINAHL 和 PEDro）系统地检索了从建立到 2019 年 1 月 8 日的文献。纳入标准为：（1）纳入有明确 MS 诊断的人类参与者；（2）参与者年龄在 18 岁或以上；（3）纳入有运动障碍的参与者（确定为平均参与者 EDSS≥6.0）；（4）评估 FES 自行车运动作为干预研究。
最初的搜索发现了 1163 项研究。其中 9 项符合全部纳入标准：5 项无前测后测的研究，没有对照组，2 项随机对照试验（RCT），1 项回顾性研究和 1 项病例研究。有 2 项研究具有相同的参与者组和干预措施，但报告了不同的结果。有 n=76 名独特的参与者的数据可用于结果数据，n=82 名参与者完成了 FES 自行车运动干预。在 n=4 篇有明确退出率的论文中，总体退出率为 25.81%。有 2 篇论文报告说，在进行 FES 自行车运动干预后，有氧能力没有显著改善。有 4 篇论文报告说下肢力量没有变化，有 2 篇论文报告说训练后痉挛性显著减少。有 4 项研究未能提供有关不良反应的信息，其他研究报告称 36 名参与者中有 n=10 例不良反应。
研究结果表明，FES 自行车训练可能会降低心血管疾病的风险，同时在训练后痉挛性也有降低的趋势，但文献质量较低，无法得出任何明确的结论。FES 自行车训练似乎在有运动障碍的 MS 患者中耐受良好，没有严重的不良反应。
