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March 2017 CME Article No. 4: Perceived Exertion is Lower When Using a Functional Electrical Stimulation Neuroprosthesis Compared with an Ankle-Foot Orthosis in Persons with Multiple Sclerosis
Additional Information
Objective:
This study investigates the direct comparison of energy cost, efficiency, and effort between an ankle-foot orthosis (AFO) and a functional electrical stimulation (FES) device for foot drop in ambulatory patients with multiple sclerosis.

Design:
Twenty adults (32–74 years old; 55% female) with a diagnosis of multiple sclerosis resulting in foot drop participated in a crossover, counterbalanced preliminary study. Each participant was tested on different days, with each session consisting of a separate walk trial per prosthetic device. Heart rate, oxygen consumption, speed, distance, and self-reported exertion were measured independently for each device walk trial. Repeated-measures analysis of variance with device and visit number as within-participants independent variables were run for the primary outcome variables of perceived exertion, energy, and metabolic efficiency.

Results:
A significant main effect of device was found for perceived exertion (P = 0.01), with participants reporting decreased exertion levels (Borg Scale) when using the FES compared with the AFO (mean difference, 1.63; 95% confidence interval, 0.49–2.76). Energy and efficiency did not significantly differ by device.

Conclusions:
Results suggest that further investigation of the potential advantages of FES devices over traditional AFO is warranted.

Learning Objectives:
  1. Describe potential differences between an AFO and FES for treatment of foot drop in MS patients
  2. Understand the mechanisms and prevalence of foot drop in MS patients
  3. Recognize the potential benefit of improved perceived exertion found when using FES for the treatment of foot drop in patients with Multiple Sclerosis
Summary
Availability: Retired
Cost: Member: $0.00
Non-Member: $15.00
Resident Member: $0.00
Resident Non-Member: $15.00
Credit Offered:
No Credit Offered
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