scholarly journals Effect of Functional Electrical Stimulation Cycling Exercise on Lower Limb Strength Asymmetry in Persons with Multiple Sclerosis

2021 ◽  
Author(s):  
John W. Farrell ◽  
Thomas Edwards ◽  
Robert W. Motl ◽  
Lara A. Pilutti
Keyword(s):  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Lower Limb ◽  
Knee Extensor ◽  
Test Time ◽  
Mobility Impairment ◽  
Knee Flexor ◽  
Lower Limb Strength ◽  
Leg Cycling ◽  
Strength Asymmetry

Abstract Background: Lower limb strength asymmetry (ie, significant difference between contralateral limbs) has been associated with mobility impairment in persons with multiple sclerosis (MS). However, whether an adaptive exercise modality can be used to modify lower limb strength and potentially improve mobility is unclear. The effect of functional electrical stimulation (FES) cycling on lower limb strength asymmetry in persons with MS with mobility impairment was assessed, and the association between change in lower limb strength asymmetries and changes in functional and self-reported mobility outcomes was explored. Methods: Eight adults with MS (Expanded Disability Status Scale scores, 5.5–6.5) were included. Outcomes included knee extensor and knee flexor strength asymmetry, Timed 25-Foot Walk (T25FW) test, 2-Minute Walk Test (2MWT), Timed Up and Go (TUG) test, and 12-item Multiple Sclerosis Walking Scale (MSWS-12). Participants received 24 weeks (three times per week) of FES cycling or passive leg cycling. Results: The FES condition demonstrated a small decrease in knee extensor (d = −0.33) and knee flexor (d = −0.23) strength asymmetry compared with passive leg cycling. With both groups combined, moderate-to-strong associations were observed between change in knee extensor asymmetry and change in T25FW test time (rs = −0.43), 2MWT time (rs = −0.24), TUG test time (rs = 0.55), and MSWS-12 score (rs = 0.43). Moderate correlations were observed between change in knee flexor asymmetry and change in T25FW test time (rs = −0.31), TUG test time (rs = 0.33), and MSWS-12 score (rs = 0.35). Conclusions: FES cycling may be an efficacious exercise modality for reducing lower limb strength asymmetry and improving mobility in persons with MS.

scholarly journals Cardiorespiratory demand of acute voluntary cycling with functional electrical stimulation in individuals with multiple sclerosis with severe mobility impairment

2018 ◽  
Vol 43 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Thomas Edwards ◽  
Robert W. Motl ◽  
Lara A. Pilutti
Keyword(s):  
Multiple Sclerosis ◽  
Oxygen Consumption ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Perceived Exertion ◽  
Peak Oxygen Consumption ◽  
Mobility Impairment ◽  
Acute Response ◽  
Cardiorespiratory Response ◽  
Leg Cycling

Exercise training is one strategy for improving cardiorespiratory fitness (CRF) in multiple sclerosis (MS); however, few modalities are accessible for those with severe mobility impairment. Functional electrical stimulation (FES) cycling is an adapted exercise modality with the potential for improving CRF in people with severe MS. The objective of this study was to characterize the cardiorespiratory response of acute voluntary cycling with FES in people with MS with severe mobility impairment, and to compare this response to passive leg cycling. Eleven participants with MS that required assistance for ambulation completed a single bout of voluntary cycling with FES or passive leg cycling. Oxygen consumption, heart rate (HR), work rate (WR), and ratings of perceived exertion (RPE) were recorded throughout the session. For the FES group, mean exercising oxygen consumption was 8.7 ± 1.8 mL/(kg·min)−1, or 63.5% of peak oxygen consumption. Mean HR was 102 ± 9.7 bpm, approximately 76.4% of peak HR. Mean WR was 27.0 ± 9.2 W, or 57.3% of peak WR, and median RPE was 13.5 (interquartile range = 5.5). Active cycling with FES was significantly (p < 0.05) more intense than passive leg cycling based on oxygen consumption, HR, WR, and RPE during exercise. In conclusion, voluntary cycling with FES elicited an acute response that corresponded with moderate-to vigorous-intensity activity, suggesting that active cycling with FES can elicit a sufficient stimulus for improving CRF.

Six minutes of walking leads to reduced lower limb strength and increased postural sway in people with Multiple Sclerosis

2014 ◽  
Vol 35 (3) ◽  
pp. 503-508 ◽  
Author(s):  
J.V. McLoughlin ◽  
C.J. Barr ◽  
M. Crotty ◽  
D.L. Sturnieks ◽  
S.R. Lord
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Postural Sway ◽  
Lower Limb Strength

scholarly journals Evaluation of Power Production Asymmetry during Cycling in Persons with Multiple Sclerosis

2019 ◽  
Vol 16 (18) ◽  
pp. 3445
Author(s):  
John W. Farrell ◽  
Debra A. Bemben ◽  
Christopher D. Black ◽  
Daniel J. Larson ◽  
Gabriel Pardo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Repeated Measures ◽  
Power Production ◽  
Current Data ◽  
Peak Oxygen Consumption ◽  
Peak Power Output ◽  
Mobility Impairment ◽  
Significant Difference ◽  
Production Asymmetry

Lower limb asymmetries have been observed in persons with multiple sclerosis (PwMS), and have been associated with mobility impairment. An incremental cycling test was performed on a cycle ergometer to determine peak power output (PPO) and peak oxygen consumption (VO2peak). Then, participants cycled at 50%, 60%, and 70% of their PPO to assess the contribution of each lower limb to power production. Two-way repeated measures ANOVA was used to detect group × intensity differences in power production asymmetry. Eight PwMS and six healthy individuals (Non-MS) completed the study. No statistically significant (p > 0.05) group × intensity interactions or main effects were present when examining between-limb differences in power production. The current data do not indicate a statistically significant difference in power production asymmetry between groups and exercise intensities. Previous research has established a 10% difference between contralateral limbs as a threshold for asymmetry. The average asymmetry in power production in PwMS exceeded the 10% threshold at all measured outputs, suggesting the presence of asymmetry in power production.

FIGC TERRITORIAL CENTERS: A PILOT STUDY TO DETERMINE THE LOWER LIMB STRENGTH ASYMMETRY IN YOUNG SOCCER PLAYERS

2017 ◽  
Vol 51 (4) ◽  
pp. 382.1-382
Author(s):  
Italo Sannicandro ◽  
Vito Tisci ◽  
Antonio Quarto ◽  
Giacomo Cofano ◽  
Anna Rosa Rosa
Keyword(s):  
Pilot Study ◽  
Lower Limb ◽  
Soccer Players ◽  
Lower Limb Strength ◽  
Strength Asymmetry

The association between anthropometric, lower limb strength, and balance variables with 5-repetition sit-to-stand test performance in physically active elderly women

2020 ◽  
Vol 28 (4) ◽  
pp. 325-331
Author(s):  
Zuzana Kováčiková ◽  
Javad Sarvestan ◽  
Zuzana Gonosova ◽  
Petr Linduska ◽  
Erika Zemkova ◽  
...  
Keyword(s):  
Lower Limb ◽  
Elderly Women ◽  
Balance Control ◽  
Knee Extensor ◽  
Physically Active ◽  
Stand Test ◽  
Sit To Stand ◽  
Knee Extensor Strength ◽  
Lower Limb Strength ◽  
Flexor Strength

BACKGROUND: Sit-to-stand test is very often used as measure of lower limb strength in elderly adults. However, the recent findings indicate that performance in this test is also influenced by other factors. OBJECTIVE: To investigate the association between anthropometric, lower limb strength, and balance variables with the 5-repetition sit-to-stand test (5RSTST) in elderly women. METHODS: Forty physically active elderly women ⩾ 60 years underwent the 5RSTST and anthropometric, balance, and lower limb strength assessment. Anthropometric measurements included height and weight. Balance was quantified in the bipedal upright stance on the basis of the centre of pressure sway in the anteroposterior (CoPAP) and mediolateral (CoPML) direction. Bilateral concentric strength of the ankle plantarflexors and dorsiflexors, knee flexors and extensors, and hip extensors was measured. RESULTS: The time to complete the 5RSTST was significantly but mildly associated with height (r= 0.356, p= 0.024), ankle dorsiflexor strength (r=-0.413, p= 0.017), knee flexor strength (r=-0377, p= 0.030), knee extensor strength (r=-0.411, p= 0.017), hip flexor strength (r=-0.359, p= 0.040) on dominant limb, and balance in both directions (AP, r= 0.651, p< 0.001; ML, r= 0.647, p< 0.001). Balance control in AP direction and knee extensor strength on dominant limb were the only factors that contributed independently to 5RSTST, accounting for 55% of the variance. Balance control in AP direction alone explained 41% of the variance in 5RSTST. CONCLUSIONS: Balance control in AP seems to be the most important factor explaining the 5RSTST performance.

scholarly journals Functional Electrical Stimulation Cycling Exercise in People with Multiple Sclerosis

2019 ◽  
Vol 21 (6) ◽  
pp. 258-264 ◽  
Author(s):  
Lara A. Pilutti ◽  
Thomas Edwards ◽  
Robert W. Motl ◽  
Emerson Sebastião
Keyword(s):  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Cognitive Processing ◽  
Cycling Exercise ◽  
Impact Scale ◽  
Leg Cycling ◽  
Related Quality ◽  
Health Related ◽  
Fatigue Severity

Abstract Background: Functional electrical stimulation (FES) cycling is an advanced rehabilitation modality that involves systematic mild electrical stimulation of focal muscle groups to produce leg cycling movement against an adjustable work rate. The present study reports on the efficacy of an assessor-blinded, pilot randomized controlled trial of supervised FES cycling exercise in people with multiple sclerosis (MS) on secondary trial outcomes, including cognition, fatigue, pain, and health-related quality of life. Methods: Eleven adult participants with MS were randomized to receive FES cycling exercise (n = 6) or passive leg cycling (n = 5) for 24 weeks. Cognitive processing speed was assessed using the Symbol Digit Modalities Test. Symptoms of fatigue and pain were assessed using the Fatigue Severity Scale, the Modified Fatigue Impact Scale, and the short-form McGill Pain Questionnaire. Physical and psychological health-related quality of life were assessed using the 29-item Multiple Sclerosis Impact Scale. Results: Eight participants (four, FES; four, passive leg cycling) completed the intervention and outcome assessments. The FES cycling exercise resulted in moderate-to-large improvements in cognitive processing speed (d = 0.53), fatigue severity (d = −0.92), fatigue impact (d = −0.45 to −0.68), and pain symptoms (d = −0.67). The effect of the intervention on cognitive performance resulted in a clinically meaningful change, based on established criteria. Conclusions: We provide preliminary evidence for the benefits of FES cycling exercise on cognition and symptoms of fatigue and pain. Appropriately powered randomized controlled trials of FES cycling exercise are necessary to determine its efficacy for people with MS.

Knee Extensor Asymmetry in Multiple Sclerosis Patients Before and After Single-Leg Cycling

2017 ◽  
Vol 49 (5S) ◽  
pp. 631
Author(s):  
David J. Lantis ◽  
Greg S. Cantrell ◽  
John P. Hintz ◽  
Daniel J. Larson ◽  
John W. Farrell ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Knee Extensor ◽  
Leg Cycling ◽  
Before And After ◽  
Multiple Sclerosis Patients

Functional electrical stimulation for foot drop in people with multiple sclerosis: The relevance and importance of addressing quality of movement

2020 ◽  
pp. 135245852092395
Author(s):  
Angela Davies Smith ◽  
Terezie Prokopiusova ◽  
Rosemary Jones ◽  
Tania Burge ◽  
Kamila Rasova
Keyword(s):  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Foot Drop ◽  
Published Data ◽  
Activity Levels ◽  
Mobility Impairment ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Quality Of Movement

Impaired mobility is common in people with multiple sclerosis (MS). Changes in gait have different causes and require individualised gait rehabilitation. A common and often early cause of mobility impairment is footdrop, inability to lift the foot during the swing phase of gait, with increased risk of falls, effortful walking and fatigue. Using literature review, we have characterised published data on footdrop treatment in MS, specifically functional electrical stimulation (FES) to better understand the reported outcomes relevant to the user. We discuss the strengths and weaknesses of FES and how far it meets the needs of people with footdrop. Physiotherapy combined with FES may further enhance the benefits of FES. MS studies emphasise the value of maintaining activity levels in early MS but discussion on how to achieve this is lacking. We emphasise the value of qualitative measures to broaden our understanding and improve treatment and adherence and identify areas for further research. Supplementary video material illustrates key features of MS gait and its correction using FES and physiotherapy.

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