Effectiveness of Functional Electrical Stimulation on Walking Speed, Functional Walking Category, and Clinically Meaningful Changes for People With Multiple Sclerosis

Abstract

ObjectiveTo determine the effectiveness of functional electrical stimulation (FES) on drop foot in patients with multiple sclerosis (MS), using data from standard clinical practice. DesignCase series with a consecutive sample of FES users collected between 2008 and 2013. SettingSpecialist FES center at a district general hospital. ParticipantsPatients with MS who have drop foot (N=187) (117 women, 70 men; mean age, 55y [range, 27–80y]; mean duration since diagnosis, 11.7y [range, 1–56y]). A total of 166 patients were still using FES after 20 weeks, with 153 patients completing the follow-up measures. InterventionsFES of the common peroneal nerve (178 unilateral, 9 bilateral FES users). Main Outcome MeasuresClinically meaningful changes (ie, >.05m/s and >0.1m/s) and functional walking category derived from 10-m walking speed. ResultsAn increase in walking speed was found to be highly significant (P<.001), both initially where a minimum clinically meaningful change was observed (.07m/s) and after 20 weeks with a substantial clinically meaningful change (.11m/s). After 20 weeks, treatment responders displayed a 27% average improvement in their walking speed. No significant training effect was found. Overall functional walking category was maintained or improved in 95% of treatment responders. ConclusionsFES of the dorsiflexors is a well-accepted intervention that enables clinically meaningful changes in walking speed, leading to a preserved or an increased functional walking category.