Thomas Edwards1, Robert W Motl2, Emerson Sebastião3, Lara A Pilutti4. 1. School of Human Kinetics, University of Ottawa, 200 Lees Avenue, Ottawa, ON K1N 6N5, Canada. 2. Department of Physical Therapy, University of Alabama at Birmingham, 1705 University Blvd., Birmingham, AL 35233-1212, USA. 3. Department of Kinesiology and Physical Education, Northern Illinois University, 1425 Lincoln Hwy, DeKalb, IL 60115 USA. 4. Interdisciplinary School of Health Sciences, Brain and Mind Research Institute, University of Ottawa, 200 Lees Avenue E250G, Ottawa, ON K1N 6N5, Canada. Electronic address: lpilutti@uottawa.ca.
Abstract
BACKGROUND:Exercise training has been shown to be beneficial for persons with multiple sclerosis (MS). Adapted exercise modalities are needed to accommodate those with severe mobility impairment (Expanded Disability Status Scale [EDSS] scores 5.5-6.5). Functional electrical stimulation (FES) cycling is one such exercise modality; however, few studies have examined the feasibility and potential benefits of FES cycling for people with MS with severe mobility impairment. OBJECTIVE: Determine the feasibility of FES cycling exercise for people with MS with severe mobility impairment, and the efficacy of FES cycling exercise for improving mobility and physiological fitness. METHODS:11 participants with MS with mobility impairment (EDSS = 5.5-6.5) were randomly allocated to FES cycling exercise (n = 6) or passive leg cycling (PLC; n = 5). Feasibility metrics included participant recruitment, retention, adherence, safety, and satisfaction. The primary mobility outcome was walking speed assessed by the Timed 25-Foot Walk (T25FW) test. The primary physiological fitness outcome was peak oxygen consumption (VO2peak), assessed using a cardiopulmonary exercise test. RESULTS:Eight participants completed the intervention (FES n = 4; PLC n = 4) with an adherence rate ≥80%. Three participants (FES n = 2, PLC n = 1) withdrew due to a lack of time. Six Grade 1 (i.e., mild) adverse events were experienced by participants in the FES group. Participants in the FES cycling condition demonstrated small-to-moderate improvements on T25FW performance (Cohen's d = 0.40; 22.9%) and VO2peak (Cohen's d = 0.34; 13.8%) compared to participants in the PLC condition. CONCLUSIONS: We provide evidence that FES cycling exercise is feasible for individuals with MS with severe mobility impairment, and might have positive effects on mobility and physiological decondition. These results will inform the design of future efficacy trials of FES cycling exercise for persons with MS with mobility disability.
RCT Entities:
BACKGROUND: Exercise training has been shown to be beneficial for persons with multiple sclerosis (MS). Adapted exercise modalities are needed to accommodate those with severe mobility impairment (Expanded Disability Status Scale [EDSS] scores 5.5-6.5). Functional electrical stimulation (FES) cycling is one such exercise modality; however, few studies have examined the feasibility and potential benefits of FES cycling for people with MS with severe mobility impairment. OBJECTIVE: Determine the feasibility of FES cycling exercise for people with MS with severe mobility impairment, and the efficacy of FES cycling exercise for improving mobility and physiological fitness. METHODS: 11 participants with MS with mobility impairment (EDSS = 5.5-6.5) were randomly allocated to FES cycling exercise (n = 6) or passive leg cycling (PLC; n = 5). Feasibility metrics included participant recruitment, retention, adherence, safety, and satisfaction. The primary mobility outcome was walking speed assessed by the Timed 25-Foot Walk (T25FW) test. The primary physiological fitness outcome was peak oxygen consumption (VO2peak), assessed using a cardiopulmonary exercise test. RESULTS: Eight participants completed the intervention (FES n = 4; PLC n = 4) with an adherence rate ≥80%. Three participants (FES n = 2, PLC n = 1) withdrew due to a lack of time. Six Grade 1 (i.e., mild) adverse events were experienced by participants in the FES group. Participants in the FES cycling condition demonstrated small-to-moderate improvements on T25FW performance (Cohen's d = 0.40; 22.9%) and VO2peak (Cohen's d = 0.34; 13.8%) compared to participants in the PLC condition. CONCLUSIONS: We provide evidence that FES cycling exercise is feasible for individuals with MS with severe mobility impairment, and might have positive effects on mobility and physiological decondition. These results will inform the design of future efficacy trials of FES cycling exercise for persons with MS with mobility disability.