Feasibility and Adherence to a 14-week Portable Neuromodulation Stimulator (PoNS) Training Program People with Multiple Sclerosis in a Real-World Setting

Research Objectives: To evaluate participants’ ability to achieve and comply with a 14-week training program utilizing PoNS, a translingual e-stimulation device, and PoNS-specific therapeutic exercise program in people with multiple sclerosis (PwMS) in a real-world clinical setting.

Design: Feasibility and adherence were evaluated by assessing completion of a 14-week, two-phase training program. The PoNS integrated rehabilitation program focused on improving walking and balance. During Phase 1, participants completed 3 supervised sessions for two weeks; during Phase 2, they completed 12 weeks of at-home unsupervised training with weekly supervised sessions.

Setting: Eula C. and Andrew C. Carlos Multiple Sclerosis (MS) Rehabilitation and Wellness Program at the Shepherd Center

Participants: Four participants (2 M, 2 F) with MS, with an average age of 56.5±15.10 years, and varying EDSS disability levels (4.5 M; 6.0 M, 2 F) completed the trial.

Interventions: The frequency, intensity, and duration were modeled after FDA-approved guidelines for PoNS training in PwMS. Six days a week participants completed a 10-minute warmup without PoNS, two 20-minute gait training sessions with PoNS, two 20-minute balance training sessions with PoNS, 20-minute movement control training session without PoNS, and a 20-minute breathing and awareness training session with PoNS. Participants could perform the sessions as preferred and selected one day each week as a rest day.

Main Outcome Measures: Adherence was remotely collected by the PoNS device, generating real-time information concerning usage parameters and stimulation intensity of PoNS sessions. Feasibility was evaluated by quantifying adherence to training frequency over the program.

Results: On average, participants received 15 supervised sessions, completed 65%±34.55% of total PoNS sessions, and 94% of completed PoNS sessions had a duration of 15-20 minutes.

Conclusions: In conclusion, preliminary analysis indicates the 14-week PoNS program is moderately feasible for PwMS. Performance of this training program in a real-world clinical setting provides novel insight regarding the feasibility of implementing FDA-approved PoNS guidelines for PwMS. Moreover, the influence on specific spatiotemporal gait parameters and the long-lasting impact of training is unknown.

Author(s) Disclosures: None