Objective:

To evaluate the effect of a Functional Electrical Stimulation (FES) sleeve on key spatiotemporal gait parameters in people with Multiple Sclerosis (PwMS) experiencing walking difficulties.

Background:

Impaired gait function, present in over 85% of PwMS, is a major cause of disability, contributing to falls and decreased independence and quality of life. FES, an active assistive technology, offers advantages over passive orthoses by stimulating key muscles to restore natural gait patterns. FES sleeves worn on the leg are commercially available to alleviate foot drop, a weakness of ankle dorsiflexion common in MS. To date, their impact on gait parameters remain understudied.

Design/Methods:

In this single-session, feasibility study, 20 adult PwMS with manual muscle test scores 1-4/5 for ankle dorsiflexion were enrolled. Participants walked on an instrumented walkway (Zeno) at comfortable and fast speeds, with and without the wearable FES sleeve (Cionic). Key spatiotemporal gait metrics corresponding to stability and speed were extracted. Patient-reported experiences with FES use were gathered using a validated usability framework.

Results:

With FES use, improvements were noted in gait stability, as measured by stride width variability during fast (median % improvement =12.4 IQR =-9.7, 38.8) and comfortable (median % =16.9 IQR =-1.8, 29.5) walking. Cadence (steps/min) also improved during preferred (median% 9.9. IQR -10.2, 25.9) and fast (median% 3.3. IQR -5.3, 11.3) walking. Over 50% participants reported subjective improvement in gait function; one reported carryover improvement with stair climbing 2 hours after removing the FES. All (100%) participants agreed that FES would positively impact quality of life for PwMS; 86% found it easy to use.

Conclusions:

In this feasibility study, immediate improvements were noted in gait stability with use of a wearable FES sleeve; acceptability and usability were high.  Longer-term trials are needed to explore sustained effects and further optimize the application and accessibility of FES for gait rehabilitation in MS.