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Use of a Foot-Induced Digitally Controlled Resistance Device for Functional Magnetic Resonance Imaging Evaluation in Patients with Foot Paresis
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Prolonged-release fampridine in multiple sclerosis: Improved ambulation effected by changes in walking pattern.

Björn Zörner1, Linard Filli2, Katja Reuter2

  • 1Department of Neurology, University Hospital Zurich, Zurich, Switzerland bjoern.zoerner@usz.ch.

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Summary

Prolonged-release fampridine (PR-fampridine) enhances walking speed and endurance in some multiple sclerosis (MS) patients. This treatment also leads to personalized gait pattern adjustments and increased daily physical activity in responders.

Keywords:
Clinical trialfampridinemultiple sclerosisoutcome measurementsymptomatic treatment

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Pharmacology

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease affecting mobility.
  • Prolonged-release fampridine (PR-fampridine), also known as 4-aminopyridine, is investigated for its potential to improve walking function in MS patients.
  • Some MS patients demonstrate improved walking speed on the timed 25-foot walk test (T25FW) with PR-fampridine treatment.

Purpose of the Study:

  • To comprehensively evaluate the effects of PR-fampridine on various aspects of walking function in MS.
  • To identify specific gait modifications associated with PR-fampridine treatment in MS patients.
  • To assess the impact of PR-fampridine on everyday physical activity levels.

Main Methods:

  • A prospective, randomized, placebo-controlled, double-blind, crossover Phase II study (FAMPKIN) was conducted.
  • Participants received either PR-fampridine (10 mg twice daily) or placebo for 6 weeks.
  • 3D motion analysis assessed gait kinematics and kinetics; clinical outcomes included T25FW, 6-minute walk test (6MWT), and balance scales. Accelerometry measured physical activity.

Main Results:

  • Analysis included data from 55 MS patients, with 17 identified as timed-walk responders to PR-fampridine.
  • Significant improvements in walking speed (T25FW) and endurance (6MWT) were observed in the overall population and responders.
  • Individualized gait pattern alterations correlated with functional improvements, and responders showed increased daily physical activity.

Conclusions:

  • PR-fampridine effectively improves walking speed, endurance, and daily physical activity in a subset of MS patients.
  • The treatment induces subject-specific modifications in gait patterns.
  • PR-fampridine represents a potential therapeutic option for enhancing mobility and function in MS.