Functional Electrical Stimulation Cycling Exercise for People with Multiple Sclerosis

There has been substantial interest in the role of exercise for managing impairments, limitations, and disability progression among persons with multiple sclerosis (MS). Despite established benefits of exercise training for persons who have mild-to-moderate MS, the ability to deliver exercise to persons who experience higher disability remains challenging. One promising approach for exercise in this population is functional electrical stimulation (FES) cycling. This review provides a summary of the current evidence for FES cycling as an exercise training modality in persons with MS with respect to prescription, safety, tolerability, and acute and chronic effects.

We searched the literature for studies involving FES cycling exercise in persons with MS published in English up until July 2019. Eight studies were retrieved: two studies examined acute effects, two studies examined chronic effects, and four studies reported on both acute and chronic effects of FES cycling exercise. The overall quality of the studies was low, with only one, small, randomized controlled trial (RCT). There is limited but promising evidence for the application of FES cycling exercise among persons with MS who have moderate-to-severe disability. Participants were capable of engaging in regular FES cycling exercise (~ 30 min, 2-3×/week), with few, mild adverse events experienced. Preliminary evidence from small, mostly uncontrolled trials supports the potential benefits of FES cycling on physiological fitness, walking mobility, and symptoms of fatigue and pain. High-quality RCTs of FES cycling exercise are necessary for providing recommendations for integrating exercise training in the management of advanced MS.