Department of Rehabilitation, Third Faculty of Medicine, Kralovske Vinohrady University Hospital, Charles University, Prague, Czech Republic.
Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, Prague, Czech Republic.
Eur J Phys Rehabil Med. 2020 Aug;56(4):394-402. doi: 10.23736/S1973-9087.20.06104-3. Epub 2020 May 8.
Functional electric stimulation (FES) is recommended for foot drop in multiple sclerosis, although little is known about its therapeutic effect.
The aim of this study is to evaluate a therapeutic effect immediately and two months after program termination (persistent and delayed effect) of a new approach using FES in combination with correcting the patients' postural system. More specifically, we evaluate the effects of this approach on the patients' clinical functions and compared it with individual physiotherapy.
Parallel randomized blind trial.
Two-month-long treatments, functional electric stimulation in posturally corrected position (group 1) and neuroproprioceptive facilitation and inhibition physiotherapy called motor program activating therapy (group 2).
Forty-four subjects with multiple sclerosis.
Primary outcomes: gait (the 2-Minute Walk Test; Timed 25-Foot Walk test; Multiple Sclerosis Walking Scale-12) and balance (by e.g. Berg Balance Scale [BBS], the Activities-Specific Balance Confidence Scale [ABC], Timed Up-and-Go Test [TUG]).
mobility, cognition, fatigue and subjects' perceptions (e.g. Multiple Sclerosis Impact Scale [MSIS], Euroqol-5 dimensions-5 levels [EQ-5D-5L]).
Group 1 showed immediate therapeutic effect in BBS (P=0.008), ABC (P=0.04) and EQ-5D-5L (self-care, P=0.019, mobility P=0.005). The improvement in EQ-5D-5L persisted and in TUG-cognitive we documented a delayed effect (P=0.005). Group 2 showed an immediate improvement in BBS (P=0.025), MSIS (P=0.043) and several aspects of daily life (the effect on health today was significantly higher than in group 1, significant difference between groups P=0.038).
FES in the posturally corrected position has an immediate therapeutic effect on balance and patients' perceptions comparable to motor program activating therapy, and higher persistent and even delayed therapeutic effect.
The study results point to the importance of correcting the patients' posture when applying FES, the possibility to treat foot drop by individual physiotherapy and the activation of the patients' auto reparative processes.
功能性电刺激（FES）被推荐用于多发性硬化症的足下垂，尽管其治疗效果知之甚少。
本研究旨在评估一种新方法的治疗效果，该方法将 FES 与纠正患者姿势系统相结合，在疗程结束后立即（即持续和延迟效应）进行评估。更具体地说，我们评估这种方法对患者临床功能的影响，并将其与个体物理治疗进行比较。
平行随机盲法试验。
为期两个月的治疗，姿势纠正位置的功能性电刺激（第 1 组）和神经本体感受促进和抑制物理疗法，称为运动程序激活疗法（第 2 组）。
44 名多发性硬化症患者。
主要结果：步态（2 分钟步行测试；定时 25 英尺步行测试；多发性硬化症步行量表-12）和平衡（例如 Berg 平衡量表[BBS]、活动特异性平衡信心量表[ABC]、起立-行走测试[TUG]）。
移动性、认知、疲劳和患者感知（例如多发性硬化症影响量表[MSIS]、欧洲五维健康量表-5 级[EQ-5D-5L]）。
第 1 组在 BBS（P=0.008）、ABC（P=0.04）和 EQ-5D-5L（自理，P=0.019，移动性，P=0.005）方面立即显示出治疗效果。EQ-5D-5L 的改善持续存在，在 TUG-认知方面我们记录到了延迟效应（P=0.005）。第 2 组在 BBS（P=0.025）、MSIS（P=0.043）和日常生活的几个方面立即显示出改善（今天的健康状况的影响明显高于第 1 组，两组之间的显著差异 P=0.038）。
姿势纠正位置的 FES 对平衡和患者感知具有即时的治疗效果，与运动程序激活疗法相当，并且具有更高的持续甚至延迟的治疗效果。
研究结果表明，在应用 FES 时纠正患者姿势的重要性、通过个体物理治疗治疗足下垂的可能性以及激活患者自动修复过程的可能性。
