FES Cycling reduces spasticity in MS patient

An article by Phillip Krause, Johann Szecsi and Andreas Straube from the University of Munich reported benefits in reducing spastic muscle tone in a patient with MS. Stimulation by means of surface electrodes applied to the thigh muscles induced cycling leg movements.

Spastic muscle tone was measured clinically using the modified Ashworth scale and semiautomatically by pendulum testing of spasticity. This was done before and directly after stimulation.

The patient was able to endure the stimulation for 30 minutes;  there was a significant reduction of spasticity after each stimulation session. The authors conclude, that this type of stimulation could be another potential treatment modality for multiple sclerosis patients, especially those with a high score in the expanded disability Status scale.

In this case study published in the Journal of NeuroRehabilitation 22 (2007) 335, 337, the authors report on a patient with multiple sclerosis who was able to tolerate FES for the induction of cycling leg movements and experienced a reduction of spastic muscle tone. 

A 46-year-old man with multiple sclerosis for more than 20 years took part in these pilot experiments. His MS episodes were initially completely remitting, but they took a secondary progressive course 10 years ago.

The patient's current clinical state was characterized by tetraparesis mainly of the lower limbs and the left side. With a score of 7.5 on the expanded disability Status scale (EDSS), he was unable to walk and used a wheelchair for most distances, including those in his home. He was able to stand up only with support.

With each training session the patient tolerated the uncomfortable sensations induced with increasing electricity (from 30 mA up to 90 mA) and became used to FES. In addition to the reduction of spasticity,  FES also has other benefits, as known from its use in spinal cord injured or stroke patients. The authors think that this case study presents another possible use of FES also for patients with MS and a higher EDSS score. It would be a positive additional physical therapy tool and can improve the mobility of such patients. However, a further systematic investigation in MS patients, also concerning the question of force development with FES training would be necessary.

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