title: Dynamic walking features and improved walking performance in multiple sclerosis patients treated with fampridine (4-aminopyridine).
abstract: BACKGROUND
  Impaired walking capacity is a frequent confinement in Multiple Sclerosis (MS). Patients are affected by limitations in coordination, walking speed and the distance they may cover. Also abnormal dynamic walking patterns have been reported, involving continuous deceleration over time. Fampridine (4-aminopyridine), a potassium channel blocker, may improve walking in MS. The objective of the current study was to comprehensively examine dynamic walking characteristics and improved walking capacity in MS patients treated with fampridine.
  
  
  METHODS
  A sample of N = 35 MS patients (EDSS median: 4) underwent an electronic walking examination prior to (Time 1), and during treatment with fampridine (Time 2). Patients walked back and forth a distance of 25 ft for a maximum period of 6 min (6-minute 25-foot-walk). Besides the total distance covered, average speed on the 25-foot distance and on turns was determined separately for each test minute, at Time 1 and Time 2.
  
  
  RESULTS
  Prior to fampridine administration, 27/35 patients (77 %) were able to complete the entire 6 min of walking, while following the administration, 34/35 patients (97 %) managed to walk for 6 min. In this context, walking distance considerably increased and treatment was associated with faster walking and turning across all six test minutes (range of effect sizes: partial eta squared = .34-.72). Importantly, previously reported deceleration across test minutes was consistently observable at Time 1 and Time 2.
  
  
  CONCLUSIONS
  Fampridine administration is associated with improved walking speed and endurance. Regardless of a treatment effect of fampridine, the previously identified, abnormal dynamic walking feature, i.e. the linear decline in walking speed, may represent a robust feature.
  
  
  CONCLUSIONS
  The dynamic walking feature might hence be considered as a candidate for a new outcome measure in clinical studies involving interventions other than symptomatic treatment, such as immune-modulating medication.
  
  
  BACKGROUND
  DRKS00009228 (German Clinical Trials Register). Date obtained: 25.08.2015.
authors.affiliation: Department of Neurology, Klinikum Bayreuth GmbH, Hohe Warte 8, 95445, Bayreuth, Germany. pmkeune@gmail.com.|Department of Physiological Psychology, Otto-Friedrich-University Bamberg, Bamberg, Germany. pmkeune@gmail.com.
authors.forename: Philipp M
authors.initials: PM
authors.lastname: Keune
authors.affiliation: Department of Life Sciences, Brunel University London, London, UK. Adam.Cocks@brunel.ac.uk.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Cocks
authors.affiliation: Department of Clinical Sciences, Brunel University London, London, UK. Will.Young@brunel.ac.uk.
authors.forename: William R
authors.initials: WR
authors.lastname: Young
authors.affiliation: Department of Neurology, Klinikum Bayreuth GmbH, Hohe Warte 8, 95445, Bayreuth, Germany. janina.burschka@googlemail.com.
authors.forename: Janina M
authors.initials: JM
authors.lastname: Burschka
authors.affiliation: Department of Neurology, Klinikum Bayreuth GmbH, Hohe Warte 8, 95445, Bayreuth, Germany. sascha.hansen@klinikum-bayreuth.de.|Department of Physiological Psychology, Otto-Friedrich-University Bamberg, Bamberg, Germany. sascha.hansen@klinikum-bayreuth.de.
authors.forename: Sascha
authors.initials: S
authors.lastname: Hansen
authors.affiliation: Department of Neurology, Klinikum Westfalen, Dortmund, Germany. u.hofstadt@gmx.de.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hofstadt-van Oy
authors.affiliation: Department of Neurology, Klinikum Bayreuth GmbH, Hohe Warte 8, 95445, Bayreuth, Germany. patrick.oschmann@klinium-bayreuth.de.
authors.forename: Patrick
authors.initials: P
authors.lastname: Oschmann
authors.affiliation: Department of Neurology, Klinikum Bayreuth GmbH, Hohe Warte 8, 95445, Bayreuth, Germany. jana.muenssinger@klinikum-bayreuth.de.
authors.forename: Jana
authors.initials: J
authors.lastname: Muenssinger
mesh_terms: D015761:4-Aminopyridine / Q000627:therapeutic use*; D000328:Adult; D035843:Biomedical Research; D003692:Delayed-Action Preparations; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D020528:Multiple Sclerosis, Chronic Progressive / Q000188:drug therapy* / Q000503:physiopathology; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000503:physiopathology; D017063:Outcome Assessment, Health Care; D026902:Potassium Channel Blockers / Q000627:therapeutic use*; D016138:Walking
chemical_list: D003692:Delayed-Action Preparations; D026902:Potassium Channel Blockers; D015761:4-Aminopyridine