Functional intermuscular reduction in spasticity for people with multiple sclerosis

Area of Science:

• Neurology
• Rehabilitation Medicine
• Physical Therapy

Background:

• Multiple sclerosis (MS) frequently causes significant gait impairments affecting daily function in 85% of individuals.
• Gait dysfunction in MS contributes to reduced mobility and quality of life.

Purpose of the Study:

• To evaluate a novel therapeutic protocol combining intermuscular electrical stimulation (IES) and functional electrical stimulation (FES) with supported bodyweight treadmill training (SBWTT).
• To assess the intervention's efficacy in improving gait, reducing spasticity and fatigue, and enhancing muscle strength in individuals with MS.

Main Methods:

• A pre-post experimental design was employed over a six-week period.
• Sixteen individuals diagnosed with MS participated in the study.
• Data analysis included summary statistics and Wilcoxon sign rank tests with Bonferroni adjustment for longitudinal pre-post comparisons.

Main Results:

• Significant improvements were observed in the Six Minute Walk Test (median increase 29.4 feet) and 25-Foot Walk Test (median decrease 0.7 s).
• Muscle strength showed gains with increases in toe taps to fatigue (median 3.8) and heel raises (median 5.0).
• Spasticity, measured by the Modified Ashworth Scale, significantly decreased after both IES and SBWTT (median change -0.5 for both).

Conclusions:

• The combined IES, FES, and SBWTT protocol shows promise for improving gait speed, endurance, and muscle strength in individuals with MS.
• The intervention effectively reduced spasticity without exacerbating fatigue.
• This novel approach offers a potential strategy for managing gait impairments in multiple sclerosis.