First results of applying electrical stimulation of muscles during walking in patients with multiple sclerosis

On the basis of a course of functional electrical stimulation (FES) in 9 patients with multiple sclerosis (MS), the authors revealed peculiarities of the method of artificial correction of movements in this cohort of patients. The authors found that the main features of the FES method, characteristic of other diseases, also remain in patients with MS. However, these patients have specific requirements for the method application, connected with their increased fatigability. Authors suppose, that the following peculiarities may be assumed as the specific ones: short duration of the session (no more than 20 minutes), small number of sessions (8-9), modest quantity of the correctional influences (no more than 4 muscles), low intensity of contraction; session termination with the appearance of minimal fatigue; necessity of complete rest for 1.5 hours before and after the session of FES. Following 76 sessions of FES in 9 patients with MS, the authors revealed the main correctional influences, necessary for this cohort of patients, peculiarities of the temporal and amplitude programs of FES, advantages of multichannel FES over the traditional single-channel FES, usually applied in patients with MS. The example of a certain patient helped the authors to find out, that as long as these conditions can be ensured, considerable improvement of the biomechanical structure of walking is observed in this patient only after 6-7 sessions of FES. This is revealed in a remarkable increase of the mean walking velocity, cadence and double step length, in the growth of stability, the diminution of the temporal, kinematic and dynamic asymmetry, in a decrease of recurvation at the knee joint, in an increase of flexion angle at the knee and hip joints, in the appearance of a new element in the curve of knee angle - flexion at the knee joint in the stance phase, in a remarkable strengthening of heel-strike and push-off of the vertical component Rz of the ground reaction force.