Effects of Functional Electrical Stimulation on Gait Function and Quality of Life for People with Multiple Sclerosis on Ampyra

Stuart SchlossmanMS Research Study and Reports

Lori Mayer, MSN, MSCN, CCRP; Tina Warring, PT; Stephanie Agrella, ANP-BC, MSCN;Helen L. Rogers, PT, PhD; Edward J. Fox, MD, PhD

From the MS Clinic of Central Texas, Central Texas Neurology Consultants, Round Rock, TX, USA (LM, TW, SA, EJF); and Innovative Neurotronics, Austin, TX, USA (HLR).
Background: Multiple sclerosis (MS) can adversely affect gait, causing gait slowing, loss of balance, decreased functional mobility, and gait deficits such as footdrop. Current treatments for gait dysfunction due to MS are pharmacologic, using Ampyra (dalfampridine), or orthotic, using an ankle-foot orthosis (AFO). Functional electrical stimulation (FES) to the fibular nerve stimulates active dorsiflexion and provides an alternative treatment for gait dysfunction caused by footdrop. The objective of this study was to determine the effect of FES on gait function and the impact of MS on walking and quality of life (QOL) for people with MS on a stable Ampyra dosage.
Methods: Subjects demonstrating gait slowing and footdrop completed the Timed 25-Foot Walk (T25FW) test, 6-Minute Walk (6MW) test, GaitRite Functional Ambulation Profile (FAP), Multiple Sclerosis Walking Scale–12 (MSWS-12), and SF-36 at screening without FES; the measures were repeated with FES at baseline, 1 month, and 3 months.
Results: Twenty subjects (8 male, 12 female) completed this unblinded case series study. The mean age, duration of MS, and time on Ampyra were 51.7, 15.8, and 1.4 years, respectively. Changes from screening to baseline and screening to 3 months were analyzed. Significant improvement was noted from screening to baseline for the MSWS-12 (P = .024) and SF-36 Physical Function domain (P = .028) and from screening to 3 months for the T25FW (P = .015), MSWS-12 (P = .003), and SF-36 Physical Function (P = .032) and Role Limitation–Physical Health domains (P = .012).
Conclusions: Improvements, above those induced pharmacologically, suggest that FES can augment pharmacologic intervention and significantly improve gait function, decrease the impact of MS on walking, and improve QOL for people with MS.
Published Online: July 14, 2014

Correspondence: Helen L. Rogers, PT, PhD, 2014 Sydnor Lane, Galveston, TX 77554; e-mail: hrogers@ininc.us.
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