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Fampridine-induced changes in walking kinetics are associated with clinical improvements in patients with multiple sclerosis
- Source :
- Journal of the Neurological Sciences. 416:116978
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Gait dysfunction is common in patients with multiple sclerosis (PwMS). Treatment with prolonged-release fampridine (PR-fampridine) improves walking ability in some PwMS. Associated fampridine-induced changes in the walking pattern are still poorly understood but may provide a better understanding of the mechanisms underlying the beneficial drug effects. 61 PwMS were treated with PR-fampridine in a randomized, monocentric, double-blind and placebo-controlled clinical trial with crossover design (FAMPKIN). Drug-induced improvements in walking speed (Timed-25-Foot Walk; T25FW) and endurance (6-Minute Walk Test; 6MWT) were quantified. In this sub-study of the FAMPKIN trial, fampridine-induced changes in kinetic gait patterns were analyzed by pressure-based foot print analysis during treadmill walking. Vertical ground reaction forces were analyzed during different gait phases. Kinetic data of 44 PwMS was eligible for analysis. During double-blind treatment with PR-fampridine, patients performed significantly better in the T25FW and 6MWT than during placebo treatment (p < 0.0001 for both). At the group level (n = 44), there were no significant changes of gait kinetics under PR-fampridine vs. placebo. However, we found relevant changes of walking kinetics regarding forces during loading, single limb and pre-swing phase in a patient sub-group (n = 8). Interestingly, this sub-group demonstrated superior responsiveness to PR-fampridine in the clinical walking tests compared to those patients without any fampridine-induced changes in kinetics (n = 36). Our results demonstrate fampridine-induced changes in gait kinetics in a sub-group of PwMS. These gait pattern changes were accompanied by improved clinical walking performance under PR-fampridine. These results shed some light on the biomechanical changes in walking patterns underlying enhanced fampridine-induced gait performance.
- Subjects :
- medicine.medical_specialty
Multiple Sclerosis
610 Medicine & health
Walking
Placebo
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
Potassium Channel Blockers
Humans
Medicine
In patient
030212 general & internal medicine
4-Aminopyridine
Ground reaction force
business.industry
Multiple sclerosis
medicine.disease
Gait
Crossover study
10040 Clinic for Neurology
Clinical trial
Preferred walking speed
Kinetics
2728 Neurology (clinical)
Treatment Outcome
Neurology
2808 Neurology
Neurology (clinical)
business
human activities
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 0022510X
- Volume :
- 416
- Database :
- OpenAIRE
- Journal :
- Journal of the Neurological Sciences
- Accession number :
- edsair.doi.dedup.....30a344e2ba17778011df94f38a60fff0