Abstract
Fampridine improves walking in patients with multiple sclerosis (PwMS). There is however little evidence suggesting it also improves the performance of activities of daily living (ADL). Therefore, we aimed to evaluate the prevalence of ADL improvement after the initial fampridine trial in relation to the improvement of walking. In this prospective study, we included 102 consecutive PwMS who were reffered for an assessment of walking before the initial prescription of fampridine. In addition to the routine 10 meter walk test (10MWT) performed by physiotherapists, the Canadian Occupational Performance Measure (COPM) was performed by occupational therapists. The tests were performed before and immediately after the initial 14 days fampridine trial. Patients were defined as responders on 10MWT if 20% improvement in time was recorded between the two measurements. Similarly we defined responders on COPM if the improvement in scores was 2 or more. Descriptive statistics and Chi 2 test to evaluate the distribution of responders and non-responders on COPM in relation to the responders on 10MWT were performed. In total, 100 PwMS (70 females, 30 males, mean age 51 ± 11 years and EDSS 5.6 ± 1) completed the study. The mean initial 10MWT time was 25.1 ± 42.7, compared to 18.3 ± 37.8 at reassessment, which resulted in 78.4% response rate to fampridine. The average initial COPM performance score was 4.6 ± 1.5 while average reassessment score was 6.1± 1.8 (39.2% response rate). The average initial COPM satisfaction score was 6.1± 1.8 and the average reassessment score was 6.5 ± 1.9 (44.1% response rate). Responders on 10MWT were very likely to improve also in COPM performance (Chi 2 P = 0.01) and satisfaction ( P = 0.01). Not only walking but also meaningful and self-chosen ADL improve in terms of PwMS’ perception and satisfaction (COPM) after fampridine treatment. It is very likely that patients who improve in walking will show significant improvement in ADL.
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