Gait quality and function after fampridine treatment in patients with multiple sclerosis - A prospective cohort study

Maria Thorning; Helle Hvilsted Nielsen; Lars Henrik Frich; Henrik Boye Jensen; Kate Lykke Lambertsen; Anders Holsgaard-Larsen

doi:10.1016/j.clinbiomech.2022.105826

Gait quality and function after fampridine treatment in patients with multiple sclerosis - A prospective cohort study

Clin Biomech (Bristol, Avon). 2022 Dec:100:105826. doi: 10.1016/j.clinbiomech.2022.105826. Epub 2022 Nov 17.

Authors

Maria Thorning¹, Helle Hvilsted Nielsen², Lars Henrik Frich³, Henrik Boye Jensen⁴, Kate Lykke Lambertsen², Anders Holsgaard-Larsen⁵

Affiliations

¹ Department of Neurology, Odense University Hospital, J.B. Winsloews Vej 4, 5000 Odense C, Denmark; Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, J.B. Winsloews Vej 19,3, 5000 Odense C, Denmark; Department of Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J.B. Winsloews Vej 21, st., 5000 Odense C, Denmark; BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, J.B. Winsloews Vej 19.3, 5000 Odense C, Denmark. Electronic address: maria.thorning.christensen@rsyd.dk.
² Department of Neurology, Odense University Hospital, J.B. Winsloews Vej 4, 5000 Odense C, Denmark; Department of Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J.B. Winsloews Vej 21, st., 5000 Odense C, Denmark; BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, J.B. Winsloews Vej 19.3, 5000 Odense C, Denmark.
³ Department of Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J.B. Winsloews Vej 21, st., 5000 Odense C, Denmark; Department of Orthopaedics, Hospital Soenderjylland, Kresten Philipsens Vej 15, 6200 Aabenraa, Denmark; Department of Regional Health Research, University of Southern Denmark, J.B Winsloews Vej 19.3, 5000 Odense C, Denmark.
⁴ Department of Brain and Nerve Diseases, Sygehus Lillebaelt, Sygehusvej 24, 6000 Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, J.B Winsloews Vej 19.3, 5000 Odense C, Denmark.
⁵ Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, J.B. Winsloews Vej 19,3, 5000 Odense C, Denmark; Department of Orthopaedics and Traumatology, Odense University Hospital, J.B. Winsloews Vej 4, 5000 Odense C, Denmark.

PMID: 36436320
DOI: 10.1016/j.clinbiomech.2022.105826

Abstract

Background: Fampridine has shown to improve walking speed, motor control, and balance in patients with multiple sclerosis. However, potential fampridine-induced changes in gait quality and underlying mechanisms, evaluated by three-dimensional gait analysis, are poorly examined. The aim was to examine if two weeks of fampridine treatment would improve gait quality (using Gait Profile Score and Gait Variable Scores from three-dimensional gait analysis) and gait function (using performance-based tests, spatiotemporal parameters, and self-perceived gait function).

Methods: 14 participants with multiple sclerosis were included (9 women and 5 men, age 53.6 ± 12.8 years, disease duration 21 ± 9.1 years) in this cohort study. Tests were completed prior to fampridine and after 14 (± 1) days of treatment. Three-dimensional gait analyses were completed, and kinematic measures were calculated for overall gait quality using Gait Profile Score, and for joint-specific variables, Gait Variable Scores. Gait function was assessed using spatiotemporal parameters, performance-based tests, and a patient-reported outcome measure. Student's paired t-test/Wilcoxon signed rank test were used to compare baseline and follow-up variables. Sample size calculation for Gait Profile Score required at least 9 participants.

Findings: No fampridine-induced improvements in gait quality were demonstrated. For gait function, improvements were found in performance-based tests (Timed 25-Foot Walk: -11.5%; Six Spot Step Test: -13.9%; 2-Minute Walk Test: 18.2%) and self-perceived gait function (12-itemMS Walking Scale: -35.2%).

Interpretation: Although two weeks of fampridine treatment in patients with multiple sclerosis improved gait function, there was no change in overall kinematic quality of gait.

Trial registration: This work was collected as a part of a registered clinical trial (MUST): ClinicalTrials.govNCT03847545.

Keywords: Fampridine; Gait function; Gait quality; Multiple sclerosis; Three-dimensional gait analysis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cohort Studies
Female
Gait
Humans
Middle Aged
Multiple Sclerosis* / drug therapy
Prospective Studies
Walking

Associated data

ClinicalTrials.gov/NCT03847545