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Objective: To determine the relative benefit of electrical stimulation (ES) and voluntary cycling exercise for persons with moderate to severe multiple sclerosis (MS). Design: Case series. Setting: Laboratory/Disabled gymnasium. Participants: 5 females with moderate to severe multiple sclerosis who were experienced with neuromuscular electrical stimulation cycling exercise. Interventions: each participant completed 3 different trials on a stationary cycle ergometer. The first trial involved 2 periods (10-min) of voluntary exercise [VOL], the second 35-min of ES cycling exercise [ES], and the third was a combination of VOL and ES [ES+VOL]. Each trial was performed on a different day. Outcome Measures: Cardiorespiratory variables (VO 2 , VCO 2 , RQ, Vt, & Br/min), cycling power output, and heart rate [HR] were measured during each session. Participants were also asked to rate each exercise trial in terms of pain (0–10) and post-exercise tiredness (0–10). Results: On average ES+VOL elicited greater acute increases in aerobic metabolic but there was no statistically detectable difference between the 3 trials except for VCO 2 . Conclusions: The application of ES may assist persons with severe MS to perform aerobic exercise. Further investigation is needed.

An exercise device, employing functional electrical stimulation (FES) of leg muscles and a seated elliptical stepping mechanism, was developed for people with neurological disabilities. A feedback motor control system was developed to maintain constant (“isokinetic”) pedalling cadence, and the device could both assist legs with poor muscle power as well as resist a stronger stepping effort. FES was employed to recruit particular leg muscle groups in a pattern that resembled voluntary elliptical stepping. To switch the electrical stimulation on and off, the pedal crank's angular position was used to identify the foot's instantaneous position throughout the movement path. Thus, key lower limb muscles (quadriceps, hamstrings, gluteals) could be exercised in this population with muscle weakness or paralysis. Stepping cadence, stimulation current level and each muscle group's stimulation angle could be modified ad-hoc, while the power output responses were monitored to fine tune the quality of leg exercise.