Study of walking parameters in patients with multiple sclerosis under fampridine: Contribution of accelerometers in the evaluation of the response to treatment

Abstract

The aim of this study is to measure the changes induced by fampridine on the spatiotemporal parameters of walk in patients with multiple sclerosis, as well as balance, endurance, physical activity and quality of life. This is a prospective monocentric preliminary study. Different evaluations were done at D0 and D14 from initiation of fampridine treatment: timed 25 feet walk (T25FW) as usually evaluated, iWalk (instrumented 6 minute walk test), iSway (instrumented balanced test) and iTUG (instrumented timed up and go test). The instrumentation included APDM ® Mobility Lab sensors. Another ambulatory accelerometry evaluation was implemented with Actigraph ® sensors and quality of life was assessed with SEP-59 survey. Twelve patients were included. The results showed: decrease of T25FW (12.1 ± 6.2 s to 10.7 ± 4.9 s, P = 0.003), increase of walking perimeter (239.0 ± 92.2 m to 281.9 ± 130.8 m, P = 0.015), increase of cadence at iWalk (89.2 ± 9.7 steps/min to 98.1 ± 12.9, P = 0.03) and significant decrease of support time during half-turn. Other parameters tend to improve, such as double support time, stride length or ambulatory energy consumption. Intergroup comparisons did not find any significant difference, but some parameters appear to be more favorable in the responder group. Finally, SEP-59 finds significant improvements in most psychological dimensions, unlike physical dimensions. Fampridine appears to induce changes on other aspects than velocity, which will have to be evaluated later with statistically more robust evaluations.