Safety and Feasibility of Various Functional Electrical Stimulation Cycling Protocols in Individuals With Multiple Sclerosis Who Are Nonambulatory.
Joy Williams, Marina Moldavskiy, Katie Bauer and 5 others
PMID 33543074WHAT IT FOUND
Nine nonambulatory adults with MS completed several functional electrical stimulation cycling protocols with no serious adverse events and minimal changes in spasticity, pain, and fatigue.
This shows safety and feasibility, not that cycling improved function.
Key findings
01No serious adverse events occurred; two orthostatic events happened after motor-assist cycling and resolved within 10 minutes.
02Average changes were small on 0-to-10 scales: spasticity 0.22±0.75, pain -0.18±0.94, fatigue -0.10±1.73.
03Five participants cycled 30 minutes in the standard protocol; four cycled 2 minutes 38 seconds without motor assist, then 30 minutes with motor assist and 10 minutes in rest intervals.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 9 participants were analyzed, so the study is too small to tell whether the cycling protocols help a wider group. There was no control group and no randomization, so it is not possible to tell whether changes were caused by cycling. Participants were nonambulatory wheelchair users with EDSS scores of 6.5 to 8.5, so results may not apply to people with MS who walk longer distances. The study was a testing and feasibility study, not a training study, so it does not establish long-term functional or quality-of-life effects. One participant withdrew from analysis for not following the protocol flow, and one large symptom increase occurred after the participant was not following the usual medication regimen. Some preliminary self-report outcomes lacked established minimal clinically important differences in MS, and the PHQ-9 worsened overall despite small group differences.
Declared interests
No funding or conflict-of-interest statement is provided in the supplied text. The equipment supplier is named as Restorative Therapies, Inc. for the RT 300 cycle.
The easy way to misread this
Do not read the MSIS-29 improvement as proof that FES cycling is an effective treatment. This was a small safety and feasibility study with no control group, and the authors state it was not a training study.