Williams Joy, Moldavskiy Marina, Bauer Katie, Reed Grace, Theuring Alexis, Zedrow Jayme, Sweatman W Mark, Backus Deborah
Multiple Sclerosis Rehabilitation and Wellness Program, Crawford Research Institute Shepherd Center, Atlanta, GA.
Crawford Research Institute, Shepherd Center, Atlanta, GA.
Arch Rehabil Res Clin Transl. 2020 Feb 12;2(2):100045. doi: 10.1016/j.arrct.2020.100045. eCollection 2020 Jun.
To examine the safety, feasibility, and response to functional electrical stimulation (FES) cycling protocols requiring differing levels of effort in people with multiple sclerosis (MS) who are nonambulatory.
Pilot study with pre-post intervention testing.
Outpatient clinic setting of a long-term acute care hospital.
Individuals (N=10) with MS (6 men; mean age 58.6±9.86y) who use a wheelchair for community mobility. Participants' Expanded Disability Status Scale score ranged from 6.5 to 8.5 (median 7.5).
Participants performed 3 or 4 FES cycling protocols requiring different levels of volitional effort during 6-8 testing sessions.
The primary outcome was safety, measured by adverse events and increase in MS symptoms, all assessed throughout, immediately post- and 1 day postsession. FES cycling performance for each protocol was also recorded. Exploratory outcome measures collected before and after all testing sessions included functional assessment of MS, MS Impact Scale, Exercise Self Efficacy Scale, Patient Health Questionnaire-9 item, and the Zarit Caregiver Burden Scale.
All participants (4 women, 6 men) completed all testing sessions. There were no serious adverse events or differences in vitals or symptoms between protocols. Two participants had an isolated episode of mild hypotension. Changes in pain, spasticity, and fatigue were minimal. Five participants were able to cycle for 30 minutes and completed interval training protocols requiring increasing difficulty. The remainder cycled for <3 minutes and completed a rest interval protocol. There was modest improvement on the exploratory outcome measures.
People with MS who use a wheelchair for community mobility can safely perform FES cycling requiring more effort than previously reported research. Therefore, the individuals may experience greater benefits than previously reported. Further study is required to better understand the potential benefits for optimizing function and improving health in people with MS.
研究功能性电刺激（FES）骑行方案在非步行的多发性硬化症（MS）患者中不同努力程度下的安全性、可行性及反应。
干预前后测试的试点研究。
长期急性护理医院的门诊诊所。
使用轮椅进行社区活动的MS患者（N = 10）（6名男性；平均年龄58.6±9.86岁）。参与者的扩展残疾状态量表评分范围为6.5至8.5（中位数7.5）。
参与者在6 - 8次测试期间进行3或4种需要不同程度自主努力的FES骑行方案。
主要结局是安全性，通过不良事件和MS症状增加来衡量，在整个过程中、每次训练后立即以及训练后1天进行评估。还记录了每个方案的FES骑行表现。在所有测试前后收集的探索性结局指标包括MS功能评估、MS影响量表、运动自我效能量表、患者健康问卷 - 9项以及扎里特照顾者负担量表。
所有参与者（4名女性，6名男性）完成了所有测试。各方案之间没有严重不良事件，生命体征或症状也没有差异。两名参与者出现了孤立的轻度低血压发作。疼痛、痉挛和疲劳的变化很小。五名参与者能够骑行30分钟并完成难度递增的间歇训练方案。其余参与者骑行时间小于3分钟并完成了休息间隔方案。探索性结局指标有适度改善。
在社区活动中使用轮椅的MS患者能够安全地进行比先前研究报告要求更高努力程度的FES骑行。因此，这些个体可能会获得比先前报告更大的益处。需要进一步研究以更好地了解优化MS患者功能和改善健康的潜在益处。
