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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

Improvements in walking speed (a) and curve speed (b) associated with treatment onset of fampridine during test minute 1–4 (N = 35). The linear deceleration trend, consistently observable at Time 1 and Time 2, was most salient on the 25-foot distance (a; see Table 3 for statistics). Error bars represent standard errors
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Fig2: Improvements in walking speed (a) and curve speed (b) associated with treatment onset of fampridine during test minute 1–4 (N = 35). The linear deceleration trend, consistently observable at Time 1 and Time 2, was most salient on the 25-foot distance (a; see Table 3 for statistics). Error bars represent standard errors

Mentions: Both main effects involved significant linear trends [25-foot-walkspeed: F(1,34) = 14.82, p <.001, partial eta squared = .30; Curvespeed: F(1,34) = 5.96, p = .02, partial eta squared = .15]. As displayed in Table 3 and Fig. 2, for minutes 1–4, significant linear deceleration trends on the 25-foot-walkspeed parameter emerged at Time 1 and Time 2. In case of the Curvespeed parameter, the linear deceleration trend did not reach significance at Time 1, whereas it was significant at Time 2 (Table 3).Table 3


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)

Improvements in walking speed (a) and curve speed (b) associated with treatment onset of fampridine during test minute 1–4 (N = 35). The linear deceleration trend, consistently observable at Time 1 and Time 2, was most salient on the 25-foot distance (a; see Table 3 for statistics). Error bars represent standard errors
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Improvements in walking speed (a) and curve speed (b) associated with treatment onset of fampridine during test minute 1–4 (N = 35). The linear deceleration trend, consistently observable at Time 1 and Time 2, was most salient on the 25-foot distance (a; see Table 3 for statistics). Error bars represent standard errors
Mentions: Both main effects involved significant linear trends [25-foot-walkspeed: F(1,34) = 14.82, p <.001, partial eta squared = .30; Curvespeed: F(1,34) = 5.96, p = .02, partial eta squared = .15]. As displayed in Table 3 and Fig. 2, for minutes 1–4, significant linear deceleration trends on the 25-foot-walkspeed parameter emerged at Time 1 and Time 2. In case of the Curvespeed parameter, the linear deceleration trend did not reach significance at Time 1, whereas it was significant at Time 2 (Table 3).Table 3

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