Abstract
Neuromuscular electrical stimulation has been used to aid musculoskeletal recovery. Excessive oxidative stress and excitoxicity are implicated in secondary progressive multiple sclerosis. A 52-year-old white female with SPMS had been scooter- and cane-dependent for 4 years. She requested and received a trial of neuromuscular electrical stimulation. Two months after initiating NMES the patient adopted several nutritional interventions to lower oxidative stress and excito-toxicity. During the first 2 months of neuromuscular electrical stimulation, the therapist observed modest gait improvements. Following the addition of nutritional interventions, more rapids gains in strength and endurance, including muscle groups not receiving neuromuscular electrical stimulation were observed by both the therapist and the patient. After 8 months of neuromuscular electrical stimulation (6 months of nutritional intervention) the patient’s function had improved sufficiently that she no longer used a scooter or cane and rode her bicycle routinely 8 miles, including hills.
Highlights
The majority of those with relapsing remitting multiple sclerosis (MS) will go onto secondary progressive MS (SPMS) within 15 years of diagnosis
Excessive oxidative stress and excitoxicity are implicated in secondary progressive multiple sclerosis
In this article we describe the use of physical therapy (PT), Neuromuscular electrical stimulation (NMES)-augmented exercises, and nutritional interventions in a patient with SPMS
Summary
The majority of those with relapsing remitting multiple sclerosis (MS) will go onto secondary progressive MS (SPMS) within 15 years of diagnosis. Two months following initiation of NMES, the patient reported that she had made multiple nutritional interventions to reduce oxidative stress and excito-toxicity (based upon her review of the medical literature). Her typical daily intake included 600 grams of cruciferous vegetables, 300 grams of brightly colored fruits or vegetables, and 60 to 100 grams of meat, poultry or fish, but no milk, eggs, or gluten-containing grains. The therapist noted an increased rate of improvements in her strength and endurance, including muscles groups not receiving electrotherapy. Six months after initiation of NMES improvements were noted in overall MS symptoms, gait disability, and fatigue disability (Table 2)
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