Effects of a functional electrical stimulation-assisted leg-cycling wheelchair on reducing spasticity of patients after stroke

Objective: To determine whether short-term propulsion of a functional electrical stimulation-assisted leg-cycling wheelchair (FES-LW) in patients with stroke can reduce spasticity of the affected leg and whether FES has additional effects on reducing spasticity. Design: Within-subject comparison. Subjects: A total of 17 patients after stroke were recruited from the university hospital. Methods: Subjects propelled 2 leg-cycling wheelchairs (the FES-LW and the LW) and a manual wheelchair along an oval pathway. The Modified Ashworth Scale (MAS), H reflex/maximal M response (H/M ratio) and relaxation index were used to evaluate the immediate effects on leg spasticity. The changes in MAS, H/M and relaxation index were used to evaluate the effect of FES in comparing 2 leg-cycling wheelchairs. Results: The MAS and H/M ratio were significantly decreased and the relaxation index significantly increased by FES-LW and LW usage. For subjects with higher muscle tone, significant lowering of the changes in MAS, H/M ratio and higher relaxation index were found for FES-LW usage compared with LW usage. Conclusion: Leg spasticity is reduced after short-term propulsion of the FES-LW and LW. The application of FES has an additional effect on reducing spasticity in subjects with higher muscle tone.