Contributions
Abstract: P1299
Type: Poster
Abstract Category: Therapy - symptomatic - Treatment of specific symptoms
Introduction: In patients with primary progressive multiple sclerosis (PPMS), walking speed increases after the treatment with fampridine. We hypothesize that fampridine would produce changes in a number of angular joint movements during gait cycle to allow this improvement in translation capacity.
Objective: To analyse the fampridine effect on gait kinematics parameters and to define which changes in gait kinematic parameters are related with walking speed improvement.
Methods: Walking speed and 37 kinematic parameters were acquired by means of instrumented gait analysis in 10 patients with PPMS before and after 15 days of treatment with fampridine (10 mg TID). Normalization with a sample of 13 healthy subjects of each parameter was calculated by the difference of Z-score before and after treatment. Random forests were used to model influence of normalization of kinematic parameters on normalization of walking speed.
Results: The model"s prediction of normalization in walking speed was acceptable (square Pearson"s r: 0.251). The most important kinematic changes to predict walking speed normalization were “range of pelvic rotation in second double support”, “range of knee flexion”, “time to peak knee flexion”, “range of ankle dorsiflexion in stance” and “dorsiflexion at initial contact”.
Conclusion: Specific kinematic changes after treatment with fampridine explain improvement in walking speed. Faster walking after fampridine is related with an increased range of knee flexion, a less retarded peak knee flexion, an increased pelvic rotation impulse in the latter support and an improved ankle dynamics in weight acceptance. Unravelling the kinematic change after fampridine in PPMS may be important to improve gait rehabilitation strategies and to enhance combinations of available therapies in the symptomatic treatment of PPMS gait disturbance.
Disclosure: Irene Pulido-Valdeolivas: Nothing to disclose
David Gómez-Andrés: Nothing to disclose
Estrella Rausell: Nothing to disclose
Juan Andres Martin Gonzalo: Nothing to disclose
Andrea Montero: Nothing to disclose
Irene Rodriguez: Nothing to disclose
Inés González-Suarez has received honoraria for speaking from Biogen and Merck
Celia Oreja-Guevara has received honoraria for speaking and/or consultancy from Biogen, Genzyme, Bayer, Merck-Sereno, Roche, Teva and Novartis.
Abstract: P1299
Type: Poster
Abstract Category: Therapy - symptomatic - Treatment of specific symptoms
Introduction: In patients with primary progressive multiple sclerosis (PPMS), walking speed increases after the treatment with fampridine. We hypothesize that fampridine would produce changes in a number of angular joint movements during gait cycle to allow this improvement in translation capacity.
Objective: To analyse the fampridine effect on gait kinematics parameters and to define which changes in gait kinematic parameters are related with walking speed improvement.
Methods: Walking speed and 37 kinematic parameters were acquired by means of instrumented gait analysis in 10 patients with PPMS before and after 15 days of treatment with fampridine (10 mg TID). Normalization with a sample of 13 healthy subjects of each parameter was calculated by the difference of Z-score before and after treatment. Random forests were used to model influence of normalization of kinematic parameters on normalization of walking speed.
Results: The model"s prediction of normalization in walking speed was acceptable (square Pearson"s r: 0.251). The most important kinematic changes to predict walking speed normalization were “range of pelvic rotation in second double support”, “range of knee flexion”, “time to peak knee flexion”, “range of ankle dorsiflexion in stance” and “dorsiflexion at initial contact”.
Conclusion: Specific kinematic changes after treatment with fampridine explain improvement in walking speed. Faster walking after fampridine is related with an increased range of knee flexion, a less retarded peak knee flexion, an increased pelvic rotation impulse in the latter support and an improved ankle dynamics in weight acceptance. Unravelling the kinematic change after fampridine in PPMS may be important to improve gait rehabilitation strategies and to enhance combinations of available therapies in the symptomatic treatment of PPMS gait disturbance.
Disclosure: Irene Pulido-Valdeolivas: Nothing to disclose
David Gómez-Andrés: Nothing to disclose
Estrella Rausell: Nothing to disclose
Juan Andres Martin Gonzalo: Nothing to disclose
Andrea Montero: Nothing to disclose
Irene Rodriguez: Nothing to disclose
Inés González-Suarez has received honoraria for speaking from Biogen and Merck
Celia Oreja-Guevara has received honoraria for speaking and/or consultancy from Biogen, Genzyme, Bayer, Merck-Sereno, Roche, Teva and Novartis.