scholarly journals Dalfampridine for Mobility Limitations in People With Multiple Sclerosis May Be Augmented by Physical Therapy: A Non-randomized Two-Group Proof-of-Concept Pilot Study

2022 ◽  
Vol 2 ◽  
Author(s):  
Prudence Plummer ◽  
Silva Markovic-Plese ◽  
Barbara Giesser

Purpose: To demonstrate proof-of-concept for a combined physical therapy and pharmacological intervention and obtain preliminary estimates of the therapeutic efficacy of a motor-relearning physical therapy intervention with and without concurrent dalfampridine treatment on gait speed in people with mobility limitations due to multiple sclerosis (MS).Methods: Using a non-randomized, two-group design, 4 individuals with MS newly prescribed dalfampridine as part of their routine medical care, and 4 individuals with MS not taking dalfampridine completed a 3-week drug run-in or no-treatment baseline, respectively. After 3 weeks, all participants commenced physical therapy twice weekly for 6 weeks. Participants taking dalfampridine took the medication for the study duration. The physical therapy program comprised functional strengthening, gait training, balance training, and dual-task training. The primary outcome was Timed 25-foot Walk (T25FW) at the end of the 6-week physical therapy program.Results: For the 4 participants taking dalfampridine, average improvement in T25FW on drug only was 12.8% (95% CI 1.2 to 24.4%). During the 6-week physical therapy phase, both groups significantly improved T25FW, but the effect tended to favor the group taking dalfampridine (mean difference = −0.93 s, 95% CI −1.9 to 0.07 s, p = 0.064, d = 1.6). Whereas the physical therapy group had average T25FW improvement of 10.8% (95% CI 1.0 to 20.5%), the physical therapy plus dalfampridine group demonstrated average improvement of 20.7% (95% CI 3.8 to 37.6%).Conclusions: Further research is warranted to examine whether dalfampridine for mobility impairment may be augmented by physical therapy in people with MS.

2018 ◽  
Vol 2 (85) ◽  
Author(s):  
Kęstutis Radžiūnas ◽  
Vytenis Trumpickas ◽  
Jonas Poderys

Research background and hypothesis. The aim of physical therapy after sports trauma is to help patients to restore physical activity as it was before injury. The participants who applied for intensive physical therapy after anterior cruciate ligament reconstructive surgery will achieve better leg muscle strength results.Research aim was to compare the effectiveness of intensive and traditional rehabilitation of the knee extensor and flexor muscle strength after the surgery for patients after anterior cruciate ligament reconstruction.Research methods. The method that we used was “Biodex Medical System 3 PRO” for the knee muscle strength. A total of 30 patients were enrolled in this study. The subjects were divided into two groups. The muscle strength was measured while leg was flexed and extended at the knee joint.Research results. The research results showed that participants who received intensive physical therapy program developed better muscle strength than in standard physical therapy group. Participant’s leg muscles recovered faster in intensive physical therapy group than in standard physical therapy group.Discussion and conclusions. The participants who received physical therapy before surgery, electrostimulation and intensive physical therapy program after surgery, achieved higher levels of knee extensor and flexor muscle strength after anterior cruciate ligament reconstructive surgery than those patients undergoing a traditional physical therapy program only after surgery.Keywords: anterior cruciate ligament, intensive physical therapy, muscle strength.


2020 ◽  
Vol 47 (4) ◽  
pp. 427-434
Author(s):  
Mohammed S. El-Tamawy ◽  
Moshera H. Darwish ◽  
Saly H. Elkholy ◽  
Engy BadrEldin S. Moustafa ◽  
Shimaa T. Abulkassem ◽  
...  

BACKGROUND: Cortical reorganization between both cerebral hemispheres plays an important role in regaining the affected upper extremity motor function post-stroke. OBJECTIVES: The purpose of the current study was to investigate the recommended number of contra-lesion low frequency repetitive transcranial magnetic stimulation (LF-rTMS) sessions that could enhance cortical reorganization post-stroke. METHODS: Forty patients with right hemiparetic subacute ischemic stroke with an age range between 50–65 yrs were randomly assigned into two equal groups: control (GA) and study (GB) groups. Both groups were treated with a selected physical therapy program for the upper limb. Sham and real contra-lesion LF-rTMS was conducted for both groups daily for two consecutive weeks. Sequential changes of cortical excitability were calculated by the end of each session. RESULTS: The significant enhancement in the cortical excitability was observed at the fourth session in favor of the study group (GB). Sequential rate of change in cortical excitability was significant for the first eight sessions. From the ninth session onwards, no difference could be detected between groups. CONCLUSION: The pattern of recovery after stroke is extensive and not all factors could be controlled. Application of LF-rTMS in conjugation with a selected physical therapy program for the upper limb from four to eight sessions seems to be efficient.


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