Fampridine and real-life walking in multiple sclerosis: Low predictive value of clinical test for habitual short-term changes
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Fampridine and real-life walking in multiple sclerosis: Low predictive value of clinical test for habitual short-term changes. / Stellmann, Jan-Patrick; Jlussi, Midia; Neuhaus, Anneke; Lederer, Christian; Daumer, Martin; Heesen, Christoph.
In: J NEUROL SCI, Vol. 368, 15.09.2016, p. 318-25.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Fampridine and real-life walking in multiple sclerosis: Low predictive value of clinical test for habitual short-term changes
AU - Stellmann, Jan-Patrick
AU - Jlussi, Midia
AU - Neuhaus, Anneke
AU - Lederer, Christian
AU - Daumer, Martin
AU - Heesen, Christoph
N1 - Copyright © 2016 Elsevier B.V. All rights reserved.
PY - 2016/9/15
Y1 - 2016/9/15
N2 - BACKGROUND: Fampridine improves walking speed in patients with multiple sclerosis (MS) in performance-based tests. The impact on habitual mobility and its correlation with clinical tests has not been analysed.OBJECTIVE: To investigate the association between clinical response criteria and habitual mobility in MS patients starting a fampridine treatment.METHODS: During a four-week baseline-to-treatment study, we assessed in 28 patients (median EDSS 4.75, range 4-6.5) walking tests as the Timed-25-Foot-Walk (T25FW) and mobility questionnaires at day 0, 14 (start of treatment) and 28. Habitual steps and distance per day, total activity and walking speed was measured by accelerometry over four weeks. Beside improvement in real-life mobility, we investigated if such measures differed between non-responders and responders defined by a 20% improvement in clinical tests.RESULTS: All clinical test, patient reported outcomes and total activity improved significantly (p<0.05). 46% improved (any change >0) in three of four real-life measures. Change of the T25FW predicted only an increase of distance per day. Subjective rating of patients performed better by predicting distance and walking speed changes correctly.CONCLUSION: Fampridine might improve walking in daily life of MS, but clinical tests are weak predictors. Accelerometry opens a new perspective on mobility measurment, but the current data do not show a consistent effect on non-performance based accelerometry outcomes.
AB - BACKGROUND: Fampridine improves walking speed in patients with multiple sclerosis (MS) in performance-based tests. The impact on habitual mobility and its correlation with clinical tests has not been analysed.OBJECTIVE: To investigate the association between clinical response criteria and habitual mobility in MS patients starting a fampridine treatment.METHODS: During a four-week baseline-to-treatment study, we assessed in 28 patients (median EDSS 4.75, range 4-6.5) walking tests as the Timed-25-Foot-Walk (T25FW) and mobility questionnaires at day 0, 14 (start of treatment) and 28. Habitual steps and distance per day, total activity and walking speed was measured by accelerometry over four weeks. Beside improvement in real-life mobility, we investigated if such measures differed between non-responders and responders defined by a 20% improvement in clinical tests.RESULTS: All clinical test, patient reported outcomes and total activity improved significantly (p<0.05). 46% improved (any change >0) in three of four real-life measures. Change of the T25FW predicted only an increase of distance per day. Subjective rating of patients performed better by predicting distance and walking speed changes correctly.CONCLUSION: Fampridine might improve walking in daily life of MS, but clinical tests are weak predictors. Accelerometry opens a new perspective on mobility measurment, but the current data do not show a consistent effect on non-performance based accelerometry outcomes.
KW - Journal Article
U2 - 10.1016/j.jns.2016.07.051
DO - 10.1016/j.jns.2016.07.051
M3 - SCORING: Journal article
C2 - 27538657
VL - 368
SP - 318
EP - 325
JO - J NEUROL SCI
JF - J NEUROL SCI
SN - 0022-510X
ER -