Improving walking in multiple sclerosis with FES cycling and dalfampridine: a case report

Research Objectives: To investigate mobility outcomes for a person with multiple sclerosis using functional electrical stimulation (FES) cycling and dalfampridine.

Design: This is a retrospective observational study of a single patient with multiple sclerosis over 68 weeks.

Setting: The study settings include an outpatient neurological physical therapy center (14 weeks) and the patient's home (46 weeks).

Participants: The patient was an ambulatory 40 year old male diagnosed with primary progressive multiple sclerosis and impaired walking function.

Interventions: The patient completed 16 sessions of FES cycling over 14 weeks of outpatient physical therapy, followed by 8 weeks with no intervention. Then, the patient began taking 10 mg of dalfampridine every 12 hours and completed 128 FES cycling sessions at home over 46 weeks.

Main Outcome Measures: The primary outcome measures were the Timed 25-Foot Walk Test (T25FW), 6 Minute Walk Test (6MWT), 10 Meter Walk Test (10MWT), Timed Up and Go Test (TUG), Five Times Sit to Stand Test (5XSST), Functional Gait Assessment (FGA), and Berg Balance Scale (BBS).

Results: Across the study, the patient's outcomes improved from 4.81 s to 3.43 s on the T25FW, 1353 ft to 1837 ft on the 6MWT, 0.979 m/s to 1.255 m/s on the 10 MWT, 8.98 s to 6.02 s on the TUG, 14.85 s to 9.46 s on the 5XSST, 16/30 to 27/30 on the FGA, and 45/56 to 54/56 on the BBS.

Conclusions: The patient in this case significantly improved his walking function with FES cycling and dalfampridine. The intervention outcomes are consistent with the available evidence for the benefits of FES cycling and dalfampridine for people with multiple sclerosis and impaired walking function, but more studies are needed to increase the level of evidence.

Author(s) Disclosures: All authors are employed by the manufacturer of one of the FES cycling devices used by the patient in this case report (MYOLYN, Inc.). M.B. and A.H. also hold stock in this organization and may gain or lose financially from the publication of this case report.