Quantification of gait kinematics and walking ability of people with multiple sclerosis who are new users of functional electrical stimulation

Abstract

Objective: To assess whether the application of Functional Electrical Stimulation improves gait kinematics and walking ability in people with multiple sclerosis who experience foot drop. Design: Acute open labelled comparative observation trial. Participants: Twelve people (3 females, 9 males, EDSS 2-4) with relapsing remitting multiple sclerosis (47.8 years (standard deviation 6.6)) who were new users of functional electrical stimulation. Methods: Gait kinematics were recorded using 3D gait analysis. Walking ability was assessed through the 10-m walk test and the 6-min walk test. All assessments were performed with and without the assistance of functional electrical stimulation. The effect of functional electrical stimulation was analysed using paired t-tests. Results: Ankle dorsiflexion at initial contact (p-=-0.026), knee flexion at initial contact (p-=-0.044) and peak knee flexion during swing (p-=-0.011) were significantly greater whilst walking with Functional Electrical Stimulation. The increased peak dorsiflexion in swing of nearly 4 degrees during functional electrical stimulation assisted walking approached significance (p-=-0.069). The 10-m walk time was significantly improved by functional electrical stimulation (p-=-0.004) but the 6 min walk test was not. Conclusion: The acute application of functional electrical stimulation resulted in an orthotic effect through a change in ankle and knee kinematics and increased walking speed over a short distance in people with multiple sclerosis who experience foot drop