Feasibility and apparent safety of functional electrical stimulation-assisted cycling in amyotrophic lateral sclerosis and primary lateral sclerosis: a single-arm longitudinal pilot feasibility study

Functional electrical stimulation-assisted cycling may be relevant in motor neuron disease, but its feasibility and safety in amyotrophic lateral sclerosis and primary lateral sclerosis remain unclear. The authors aimed to assess feasibility, apparent safety, and exploratory pre-post clinical changes of a three-week functional electrical stimulation-assisted cycling protocol in ambulatory inpatients with amyotrophic lateral sclerosis or primary lateral sclerosis. Fifteen patients were assessed; 11 were enrolled (5 ALS, 6 PLS) and received 15 supervised 30-minute FES-cycling sessions over three weeks in addition to conventional neuromotor rehabilitation. Bilateral eight-channel stimulation targeted quadriceps, tibialis anterior, hamstrings, and gastrocnemius during active or active-assisted cycling. Feasibility outcomes were enrollment, completion, tolerance, adverse events, and pre-post data availability. Clinical outcomes were analyzed descriptively. Eleven of 15 assessed patients were enrolled (73.3%; 5 ALS, 6 PLS). All enrolled participants completed the protocol, no adverse events were documented, and complete pre-post data were available. Exploratory outcomes showed favorable short-term changes in mobility, walking, strength, and spasticity. This protocol appears feasible and apparently safe in selected ambulatory inpatients. Findings are hypothesis-generating and support a prospective controlled feasibility trial before efficacy is tested.