CP-159 Assessment of effectiveness in walking ability and safety of fampridine in multiple sclerosis patients

Background: Multiple sclerosis is a progressive neurodegenerative disease that affects myelin in the central nervous system. It is complex and unpredictable and occurs predominantly in young adults, causing increasing disability and a significantly lower quality of life. Recent studies investigated how rehabilitation training through the use of a robotic exoskeleton can influence walking recovery in patients with a serious neurological disease. Aim: The purpose of this study was to analyze the first approach of a multiple sclerosis patient to a robotic exoskeleton for the lower limbs, in order to assess the effectiveness of the protocol on walking ability, adaptability of the device, level of appreciation, variations in parameters related to walking, and fatigue perception. Methods: This study was conducted on a 71-year-old male diagnosed with primary progressive multiple sclerosis since 2012, with an EDSS score of 6. The patient underwent a cycle of 10 sessions of treatment with the exoskeleton for the lower limbs, the UAN.GO, lasting 1 h 30 min. Pre- and post-treatment evaluations were carried out with the 6 min walking test, the Fatigue Severity Scale, the Short Form-36 Health Survey, and a Likert scale for review. During each session, blood pressure, heart rate, and peripheral saturation were monitored; in addition, the perception of fatigue by the Borg scale was studied. Result: A comparison between the initial and final evaluations showed improvements in the walked distance at 6 MWT (T0 = 53 m/T1 = 61 m). There was a positive trend in saturation and heart rate values collected during each session. Further improvements were found by the Borg scale (T0 = 15/T1 = 11). Discussion: The data collected in this case report show promising results regarding the treatment of multiple sclerosis patients with the UAN.GO exoskeleton, with benefits on both motor performance and vital parameters.

Download Full-text

Correlation analysis of visual analogue scale and measures of walking ability in multiple sclerosis patients

Acta Neurologica Belgica ◽

10.1007/s13760-013-0187-5 ◽

2013 ◽

Vol 113 (4) ◽

pp. 397-402 ◽

Cited By ~ 5

Author(s):

Petar Filipović Grčić ◽

Meri Matijaca ◽

Ivica Bilić ◽

Gordan Džamonja ◽

Ivo Lušić ◽

...

Keyword(s):

Multiple Sclerosis ◽

Visual Analogue Scale ◽

Correlation Analysis ◽

Analogue Scale ◽

Walking Ability ◽

Multiple Sclerosis Patients

Download Full-text

Development of a gait module to complement the 12-item Multiple Sclerosis Walking Scale: a mixed methods study

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217318783766 ◽

2018 ◽

Vol 4 (2) ◽

pp. 205521731878376 ◽

Cited By ~ 1

Author(s):

Sara Strzok ◽

Sophie Cleanthous ◽

Farrah Pompilus ◽

Stefan J Cano ◽

Patrick Marquis ◽

...

Keyword(s):

Multiple Sclerosis ◽

Mixed Methods ◽

Measurement Theory ◽

Rasch Measurement ◽

Mixed Methods Study ◽

Walking Ability ◽

Rasch Measurement Theory ◽

Outcome Instrument ◽

Multiple Sclerosis Patients ◽

Higher Functioning

Background and objective The 12-item Multiple Sclerosis Walking Scale (MSWS-12) is a patient-reported outcome instrument that quantifies the progressive loss of walking ability from the patient perspective. However, previous psychometric analyses indicated floor and ceiling effects across the multiple sclerosis severity spectrum. This study aimed to address floor effects by creating a gait module that can be used in conjunction with the MSWS-12 for better measurement of treatment benefit in the higher functioning multiple sclerosis population. Methods We used a step-wise mixed methods study design, with relapsing–remitting multiple sclerosis patients (wave 1, n=88; wave 2, n=30), combining qualitative (concept elicitation and cognitive debriefing interviews) and quantitative (Rasch Measurement Theory) data collection and analytical techniques and consultation interviews with three neurologists specializing in multiple sclerosis. Results Thirty-seven walking ability concepts were identified, and a five-domain conceptual framework was created. Draft items were generated and refined with patient and neurologist input. Draft items covered gait-related concepts such as dragging, shuffling, limping, tripping and falling. Rasch measurement theory psychometric analysis indicated administering MSWS-12 plus gait items improved measurement precision in targeted populations with better walking ability. Conclusion Study findings indicate that new gait items could improve sensitivity to detect clinical change in walking ability for higher functioning multiple sclerosis patients.

Download Full-text

Self-directed exercise in multiple sclerosis: Evaluation of a home automated tele-management system

Journal of Telemedicine and Telecare ◽

10.1177/1357633x17702757 ◽

2017 ◽

Vol 24 (6) ◽

pp. 410-419 ◽

Cited By ~ 11

Author(s):

Susan S Conroy ◽

Min Zhan ◽

William J Culpepper ◽

Walter Royal ◽

Mitchell T Wallin

Keyword(s):

Multiple Sclerosis ◽

Management System ◽

Exercise Adherence ◽

Progressive Multiple Sclerosis ◽

Walking Ability ◽

Control Groups ◽

Home Based ◽

Significant Difference ◽

Multiple Sclerosis Patients ◽

Minute Walk

Introduction Physical rehabilitation is one of the few non-pharmaceutical therapies for maintaining or improving walking ability for patients with multiple sclerosis. However, travel distance to rehabilitation clinics, neurological disability and insurance coverage often limit access to specialised rehabilitation services. To address these issues, we utilised a web-based system to support a home-based self-directed exercise programme. Methods Patients ( n = 24) were randomised to either routine home rehabilitation or to the multiple sclerosis home automated tele-management system for a six-month period. The study group had a mean age of 50.4 years, 56% of patients were male, and 67% had progressive multiple sclerosis with an overall mean Patient Determined Disease Steps score of 4.4 (cane or crutch required for walking). Key outcomes included the timed 25-foot-walk, six-minute-walk and the Berg Balance Scale. Results There was no statistically significant difference in the change of the primary walking outcome measure, timed 25-foot-walk, at six months between the home automated tele-management intervention and control groups ( p = 0.44). Similarly, change scores for the six-minute-walk were not significantly different between the home automated tele-management or control groups at six months. Discussion Maintaining overall gait abilities in this group of predominantly progressive multiple sclerosis patients is notable. Exercise adherence was positively associated with higher multiple sclerosis disability and self-reported walking ability. Study engagement and participation in routine home-based exercise for the entire study period was challenging. Further research using clinical video telerehabilitation techniques that optimise patient involvement warrants further study.

Download Full-text