Using Wearable Sensors and Video Analysis to Improve Functional Electrical Stimulation Prescription in Individuals With Multiple Sclerosis: A Case Series

Background: A growing body of evidence supports the use of functional electrical stimulation (FES) in people with multiple sclerosis (MS). However, prescription remains an imprecise process with no well-established guidelines for assessing the immediate or long-term effects to ensure maximum benefit. The purpose of this case series was to assess the potential benefits of using wearable sensors and video analysis to provide immediate feedback on gait performance to improve FES prescription in people with MS. Methods: Three adults (2 women, 1 man; age range, 39-62 years) with MS with varying levels of lower extremity motor function and gait impairment were enrolled. During a single visit, participants performed a series of 10-m walks under various FES and non-FES conditions while using wearable motion sensors. Additionally, 2D video analysis was used to assess alterations in knee angles during swing and stance phases. Results: All participants demonstrated improvements in a variety of gait variables, including a clinically meaningful (> 0.1 m/s) increase in gait speed during 1 or more of the FES conditions when compared with the no-device and/or prescribed ankle foot orthosis conditions. There were additional improvements associated with multichannel stimulation of the lower leg and thigh for certain gait variables. Conclusions: Data from the wearable sensors and video analysis were advantageous in helping researchers determine the most appropriate FES prescription for each participant. This case series demonstrates the potential clinical usefulness of these technologies in prescribing FES for people with MS.