Gann Elliot J, Mañago Mark M, Allen Diane D, Celnikier Elie, Block Valerie J
From the Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO.
Department of Physical Therapy and Rehabilitation Science, University of California at San Francisco, San Francisco, CA.
Int J MS Care. 2024 Aug 12;26(Q3):214-223. doi: 10.7224/1537-2073.2023-081. eCollection 2024 May.
Foot drop in people with multiple sclerosis (MS) commonly leads to decreased mobility and quality of life (QOL). Functional electrical stimulation (FES) of the peroneal nerve can improve the gait of people with foot drop, yet various barriers restrict widespread use. The purpose of this case series was to examine the feasibility of a telerehabilitation-monitored FES device and report changes in functional mobility and QOL in people with moderate MS-related disability.
FES use was progressed over 8 weeks via 3 telerehabilitation sessions. Feasibility of telerehabilitation was assessed by percentage of telerehabilitation visits completed and participant-reported satisfaction. At baseline and study completion, functional mobility with and without FES were assessed by the Timed 25-Foot Walk (T25FW), Timed Up and Go (TUG), and 2-Minute Walk Test (2MWT), Multiple Sclerosis Impact Scale (MSIS-29), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Fatigue was assessed via the Modified Fatigue Impact Scale (MFIS) before and after the intervention.
Eleven participants (mean age = 50.4 years [SD 10.8]; 2 males) completed the study. All (33/33) telerehabilitation visits were completed and participants attained high levels of satisfaction with no adverse events. At 8 weeks, compared to baseline, there were clinically meaningful improvements on the T25FW, 2MWT, and TUG for 45%, 55%, and 82% of participants, respectively. Clinically meaningful improvements on the MSIS-29 and MSWS-12 were also recorded for 64% and 36% of participants, respectively.
Telerehabilitation was safe and feasible for FES intervention, and improvements in functional mobility and QOL were observed. Telerehabilitation to monitor FES may improve access and reduce patient burden; therefore, studying its efficacy is warranted.
多发性硬化症（MS）患者的足下垂通常会导致活动能力下降和生活质量（QOL）降低。腓总神经的功能性电刺激（FES）可以改善足下垂患者的步态，但各种障碍限制了其广泛应用。本病例系列的目的是研究远程康复监测的FES设备的可行性，并报告中度MS相关残疾患者的功能活动能力和生活质量的变化。
通过3次远程康复治疗，在8周内逐步增加FES的使用。通过完成的远程康复治疗次数百分比和参与者报告的满意度来评估远程康复的可行性。在基线和研究结束时，通过25英尺定时步行（T25FW）、起身行走计时测试（TUG）和2分钟步行测试（2MWT）、多发性硬化症影响量表（MSIS-29）以及12项多发性硬化症步行量表（MSWS-12）评估有无FES时的功能活动能力。在干预前后通过改良疲劳影响量表（MFIS）评估疲劳情况。
11名参与者（平均年龄 = 50.4岁 [标准差10.8]；2名男性）完成了研究。所有（33/33）次远程康复治疗均完成，参与者满意度高，无不良事件发生。在8周时，与基线相比，分别有45%、55%和82%的参与者在T25FW、2MWT和TUG上有临床意义的改善。分别有64%和36%的参与者在MSIS-29和MSWS-12上也有临床意义的改善。
远程康复用于FES干预是安全可行的，且观察到功能活动能力和生活质量有所改善。监测FES的远程康复可能会改善可及性并减轻患者负担；因此，有必要研究其疗效。
