01-06-2002, 10:48 AM
I was under the imppression that passive exercise was of no value. I came across this link to one article from the MS society of Ireland on its benefits. http://www.ms-society.ie/msnews/issue57/26exercise.html
I have not done any further research on this topic. Are you aware of any research on this? Can you make any comments on if you think it is beneficial for reducing edema and spasms?
I have MS, EDSS 8.5
01-06-2002, 05:58 PM
I am not sure where the notion "passive" exercise is ineffective came from. There is no data. Besides, if rehabilitation doctors truly believed that passive exercise is ineffective, they would not be prescribing passive range of motion exercises and physical therapists would not be doing so much of it.
Stretching of muscles will activate reflexes. Particularly in people with spasticity, it will activate stretch reflexes that causes the muscle to be activated. This should activate the muscle. However, if the cycling movement is combined with FES, one would expect the results to be even more effective because you are getting both the stretch reflex and the electrical stimulation effect.
I noticed that this device has resistance detectors that will stop the bicycling motion when it detects resistance against the movement, so as not to hurt the patient. That is good. However, I think that it will be important to do a rigorous clinical trial comparing passive mechanical cycling to FES cycling, to see if there are differences in heart rate and other physiological responses to the exercise.
By the way, the answer may be different for complete versus incomplete injury, spinal cord injury versus multiple sclerosis. Clearly, for somebody with flaccid muscles, passive exercise is unlikely to do much because it will not activate stretch reflexes or muscle activation. For somebody with no sensation, i.e. complete spinal cord injury, high muscle stimulation levels can be used with the FES cycling. For somebody with partial sensation or even pain, the electrical stimulation may be intolerable. In that case, perhaps the passive cycling will be the only way to go.