Effects of Para-Spinal Repetitive Magnetic Stimulation on Multiple Sclerosis Related Spasticity

Abstract

Introduction: Spasticity is a major problem in multiple sclerosis (MS) patients directly affecting their quality of life. Despite having many treatment modalities, the clinical effectiveness of these modalities is at best modest. Aim of the Study: The aim of this study was to test the effectiveness of repetitive peripheral magnetic stimulation (rpms) in decreasing spasticity and painful cramps in the lower extremities of MS patients. A secondary objective was to know whether this postulated improvement would result in an increase in the speed of walking of these patients. Patients and Methods: Twenty six MS cases were randomly assigned either to 6 sessions of active 1 Hz rpms over the paravertebral region bilaterally (Group 1; n=18) or to sham stimulation (Group 2; n=8). Outcome measures included the Modified Ashworth Scale (MAS) for spasticity, self-reported spasm frequency and degree of pain associated with it, generalized body pains and 25 feet walking test. All measures were examined at baseline, after the end of treatment, and 2 and 4 weeks later. EDSS of all study patients did not exceed 6.5. Results: There was no significant difference between the two studied groups at baseline. There was a significant difference between the two study groups in terms of muscle spasticity tested by MAS (p= 0.05), and spasm frequency and intensity (p<0.0001 for both). There was no significant difference between the two study groups in terms of duration taken to complete the 25 feet test or generalized body pain. There was no significant difference between relapsing remitting and secondary progressive MS cases receiving active stimulation. Conclusions: Rpms helps ameliorating MS related spasticity and muscle spasms. Further studies are needed to look into the effects of this improvement on the quality of life and the activities of daily living of those patients.