Randomized comparison of functional electric stimulation in posturally corrected position and motor program activating therapy: treating foot drop in people with multiple sclerosis
| Autor: | Marketa Pavlikova, Magdalena Markova, Terezie Prokopiusova, Kamila Rasova |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Foot drop Multiple Sclerosis medicine.medical_treatment Population Physical Therapy Sports Therapy and Rehabilitation Electric Stimulation Therapy Walk Test law.invention Disability Evaluation Physical medicine and rehabilitation Randomized controlled trial law medicine Humans Single-Blind Method education Peroneal Neuropathies Postural Balance Gait Disorders Neurologic Balance (ability) education.field_of_study Rehabilitation business.industry Therapeutic effect Middle Aged Gait Berg Balance Scale Female medicine.symptom business |
| Zdroj: | European journal of physical and rehabilitation medicine. 56(4) |
| ISSN: | 1973-9095 |
| Popis: | Background Functional electric stimulation (FES) is recommended for foot drop in multiple sclerosis, although little is known about its therapeutic effect. Aim The aim of this study is to evaluate a therapeutic effect immediately and two months after program termination (persistent and delayed effect) of a new approach using FES in combination with correcting the patients' postural system. More specifically, we evaluate the effects of this approach on the patients' clinical functions and compared it with individual physiotherapy. Design Parallel randomized blind trial. Setting Two-month-long treatments, functional electric stimulation in posturally corrected position (group 1) and neuroproprioceptive facilitation and inhibition physiotherapy called motor program activating therapy (group 2). Population Forty-four subjects with multiple sclerosis. Methods Primary outcomes: gait (the 2-Minute Walk Test; Timed 25-Foot Walk test; Multiple Sclerosis Walking Scale-12) and balance (by e.g. Berg Balance Scale [BBS], the Activities-Specific Balance Confidence Scale [ABC], Timed Up-and-Go Test [TUG]). Secondary outcomes mobility, cognition, fatigue and subjects' perceptions (e.g. Multiple Sclerosis Impact Scale [MSIS], Euroqol-5 dimensions-5 levels [EQ-5D-5L]). Results Group 1 showed immediate therapeutic effect in BBS (P=0.008), ABC (P=0.04) and EQ-5D-5L (self-care, P=0.019, mobility P=0.005). The improvement in EQ-5D-5L persisted and in TUG-cognitive we documented a delayed effect (P=0.005). Group 2 showed an immediate improvement in BBS (P=0.025), MSIS (P=0.043) and several aspects of daily life (the effect on health today was significantly higher than in group 1, significant difference between groups P=0.038). Conclusions FES in the posturally corrected position has an immediate therapeutic effect on balance and patients' perceptions comparable to motor program activating therapy, and higher persistent and even delayed therapeutic effect. Clinical rehabilitation impact The study results point to the importance of correcting the patients' posture when applying FES, the possibility to treat foot drop by individual physiotherapy and the activation of the patients' auto reparative processes. |
| Databáze: | OpenAIRE |
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