Evaluating the Effect of Functional Electrical Stimulation Used for Foot Drop on Aspects of Health-Related Quality of Life in People with Multiple Sclerosis

Abstract

Background: Multiple sclerosis (MS) is a common degenerative neurologic condition resulting in walking difficulties. Foot drop is a common walking impairment in MS that can affect health-related quality of life (HRQOL). Functional electrical stimulation (FES) can improve walking in people with MS, but its effect on HRQOL is not well established. This review investigated the effect of FES used for foot drop on HRQOL in adults with MS. Methods: A systematic search was performed using CINAHL, MEDLINE, Cochrane Library, PubMed, and PEDro online databases. Inclusion and exclusion criteria were applied to select eligible studies. Data were extracted, and two reviewers independently rated the quality of the studies using the Effective Public Health Practice Project assessment tool. Results: Eight studies were eligible for review; seven were of moderate-to-strong methodological quality and one was weak. Seven studies demonstrated significant positive effects of FES on different aspects of HRQOL as measured by the 29-item Multiple Sclerosis Impact Scale, 36-item Short Form Health Status Survey, Canadian Occupational Performance Measure, and Psychosocial Impact of Assistive Devices Scale. Conclusions: This review provides preliminary evidence that FES has a positive effect on aspects of HRQOL in people with MS; however, the variety of HRQOL outcomes used makes it difficult to determine definitive conclusions. Future larger-scale randomized studies with long-term follow-up are recommended to better understand the effect of FES on HRQOL. This will inform prescribing decisions and support compliance with FES over the longer-term.

Effects of brain-computer interface with functional electrical stimulation for gait rehabilitation in multiple sclerosis patients: preliminary findings in gait speed and event-related desynchronization onset latency

“…With respect to the EQ5D5L VAS scale, the patients involved in our study expressed a positive effect or no change in health-related quality of life after the BCI-FES therapy. These results are in accordance with the literature about FES to assist foot drop when walking freely [53].…”

Functional electrical stimulation to aid walking in patients with adrenomyeloneuropathy: A case study and observational series

“… 7 , 8 Additional benefits from the use of FES include improvements in overactive bladder symptoms, 9 as well as demonstrated improvement in quality of life in people with multiple sclerosis. 10 Most research involving FES has focussed on patients with multiple sclerosis 11 or stroke 12 reflecting the increased prevalence of these conditions in adults with walking difficulties secondary to upper motor neuron lesions. However, FES has also been used successfully in a range of other neurological disorders, including hereditary spastic paraplegia, 13 spinal cord injuries 14 and more recently Parkinson's disease.…”

Functional Electrical Stimulation for Physiotherapy Management of Neurological Conditions: An Evidence Based Study

“…Strong evidence suggests that FES when applied for foot drop in patients with Multiple Sclerosis has initial and ongoing orthotic effect on gait speed in short walking test and also has significant effect on energy cost of walking and HRQOL such as impact of MS perceived activities of daily living performance, competence, selfesteem and confidence in adults with MS. Studies were done in which peroneal nerve stimulation was given for foot drop. (16)(17)(18) Liva Popa et al (19) conducted a study finding effect on bradykinesia in Parkinsonian patients. Modest improvement in upper limb function was noted when compared to lower limb.…”