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Dynamic walking features and improved walking performance in multiple sclerosis patients treated with fampridine (4-aminopyridine).

Keune PM, Cocks AJ, Young WR, Burschka JM, Hansen S, Hofstadt-van Oy U, Oschmann P, Muenssinger J - BMC Neurol (2015)

Bottom Line: Besides the total distance covered, average speed on the 25-foot distance and on turns was determined separately for each test minute, at Time 1 and Time 2.Importantly, previously reported deceleration across test minutes was consistently observable at Time 1 and Time 2.Fampridine administration is associated with improved walking speed and endurance.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Klinikum Bayreuth GmbH, Hohe Warte 8, 95445, Bayreuth, Germany. pmkeune@gmail.com.

ABSTRACT

Background: Impaired walking capacity is a frequent confinement in Multiple Sclerosis (MS). Patients are affected by limitations in coordination, walking speed and the distance they may cover. Also abnormal dynamic walking patterns have been reported, involving continuous deceleration over time. Fampridine (4-aminopyridine), a potassium channel blocker, may improve walking in MS. The objective of the current study was to comprehensively examine dynamic walking characteristics and improved walking capacity in MS patients treated with fampridine.

Methods: A sample of N = 35 MS patients (EDSS median: 4) underwent an electronic walking examination prior to (Time 1), and during treatment with fampridine (Time 2). Patients walked back and forth a distance of 25 ft for a maximum period of 6 min (6-minute 25-foot-walk). Besides the total distance covered, average speed on the 25-foot distance and on turns was determined separately for each test minute, at Time 1 and Time 2.

Results: Prior to fampridine administration, 27/35 patients (77 %) were able to complete the entire 6 min of walking, while following the administration, 34/35 patients (97 %) managed to walk for 6 min. In this context, walking distance considerably increased and treatment was associated with faster walking and turning across all six test minutes (range of effect sizes: partial eta squared = .34-.72). Importantly, previously reported deceleration across test minutes was consistently observable at Time 1 and Time 2.

Discussion: Fampridine administration is associated with improved walking speed and endurance. Regardless of a treatment effect of fampridine, the previously identified, abnormal dynamic walking feature, i.e. the linear decline in walking speed, may represent a robust feature.

Conclusions: The dynamic walking feature might hence be considered as a candidate for a new outcome measure in clinical studies involving interventions other than symptomatic treatment, such as immune-modulating medication.

Trial registration: DRKS00009228 (German Clinical Trials Register). Date obtained: 25.08.2015.

No MeSH data available.


Related in: MedlinePlus

Illustration of the implemented walking test involving light sensors (1–4) and the examined straight distance (A) and curves (B). See methods section for details on the derivation of respective walking parameters
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Fig1: Illustration of the implemented walking test involving light sensors (1–4) and the examined straight distance (A) and curves (B). See methods section for details on the derivation of respective walking parameters

Mentions: At each of the two assessment points, patients completed a walking test, which required them to repeatedly cover a distance of 25 ft throughout a maximal assessment period of 6 min. Patients were instructed to walk as enduring and fast as possible in context of their walking disability. An illustration of the general outline of the walking test is displayed in Fig. 1.Fig. 1


Dynamic walking features and improved walking performance in multiple sclerosis patients treated with fampridine (4-aminopyridine).

Keune PM, Cocks AJ, Young WR, Burschka JM, Hansen S, Hofstadt-van Oy U, Oschmann P, Muenssinger J - BMC Neurol (2015)

Illustration of the implemented walking test involving light sensors (1–4) and the examined straight distance (A) and curves (B). See methods section for details on the derivation of respective walking parameters
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4581460&req=5

Fig1: Illustration of the implemented walking test involving light sensors (1–4) and the examined straight distance (A) and curves (B). See methods section for details on the derivation of respective walking parameters
Mentions: At each of the two assessment points, patients completed a walking test, which required them to repeatedly cover a distance of 25 ft throughout a maximal assessment period of 6 min. Patients were instructed to walk as enduring and fast as possible in context of their walking disability. An illustration of the general outline of the walking test is displayed in Fig. 1.Fig. 1

Bottom Line: Besides the total distance covered, average speed on the 25-foot distance and on turns was determined separately for each test minute, at Time 1 and Time 2.Importantly, previously reported deceleration across test minutes was consistently observable at Time 1 and Time 2.Fampridine administration is associated with improved walking speed and endurance.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Klinikum Bayreuth GmbH, Hohe Warte 8, 95445, Bayreuth, Germany. pmkeune@gmail.com.

ABSTRACT

Background: Impaired walking capacity is a frequent confinement in Multiple Sclerosis (MS). Patients are affected by limitations in coordination, walking speed and the distance they may cover. Also abnormal dynamic walking patterns have been reported, involving continuous deceleration over time. Fampridine (4-aminopyridine), a potassium channel blocker, may improve walking in MS. The objective of the current study was to comprehensively examine dynamic walking characteristics and improved walking capacity in MS patients treated with fampridine.

Methods: A sample of N = 35 MS patients (EDSS median: 4) underwent an electronic walking examination prior to (Time 1), and during treatment with fampridine (Time 2). Patients walked back and forth a distance of 25 ft for a maximum period of 6 min (6-minute 25-foot-walk). Besides the total distance covered, average speed on the 25-foot distance and on turns was determined separately for each test minute, at Time 1 and Time 2.

Results: Prior to fampridine administration, 27/35 patients (77 %) were able to complete the entire 6 min of walking, while following the administration, 34/35 patients (97 %) managed to walk for 6 min. In this context, walking distance considerably increased and treatment was associated with faster walking and turning across all six test minutes (range of effect sizes: partial eta squared = .34-.72). Importantly, previously reported deceleration across test minutes was consistently observable at Time 1 and Time 2.

Discussion: Fampridine administration is associated with improved walking speed and endurance. Regardless of a treatment effect of fampridine, the previously identified, abnormal dynamic walking feature, i.e. the linear decline in walking speed, may represent a robust feature.

Conclusions: The dynamic walking feature might hence be considered as a candidate for a new outcome measure in clinical studies involving interventions other than symptomatic treatment, such as immune-modulating medication.

Trial registration: DRKS00009228 (German Clinical Trials Register). Date obtained: 25.08.2015.

No MeSH data available.


Related in: MedlinePlus