Neuromuscular electrical stimulation cycling exercise for persons with advanced multiple sclerosis

Objective: To investigate the feasibility of neuromuscular electrical stimulation cycling modified to suit persons with advanced multiple sclerosis. Subjects: Eight women with secondary progressive multiple sclerosis. Methods: Subjects participated in an 18-session (40 min) neuromuscular electrical stimulation cycling program. A pedaling cadence of 10 rev•min-1 was employed and stimulation intensity was not modulated to control cadence, but increased gradually throughout each session. The outcomes included the stimulation intensity tolerated, thigh circumference changes, and power output and cardiorespiratory response during cycling. Participants were interviewed about perceived benefits of the treatment including changes in transfer ability. Results: Seven participants (Expanded Disability Status Scale 6.5–8.5) (mean 7.4 (standard deviation 0.7)) completed the training program over an average of 10 weeks. Greater stimulation intensities were tolerated than previously reported for persons with multiple sclerosis. Increases were found in thigh volume. Perceived benefits included improvements in transfer ability, leg circulation, spasticity and strength. Conclusion: Modifying neuromuscular electrical stimulation cycling allowed persons with advanced multiple sclerosis to tolerate greater stimulation intensities and exercise their muscles more intensely than previous studies. The benefits reported, which were solely due to neuromuscular electrical stimulation cycling, demonstrate that persons with preserved sensation and muscle paralysis/paresis might benefit from neuromuscular electrical stimulation exercise when it is adjusted appropriately.