Effect of dalfamprine on spatiotemporal gait parameters in multiple sclerosis
Ms Laurine ABADIEa, Mr Marc-Alexandre GUYOTa, Dr Hichem KHENIOUIa, Mr Olivier AGNANIa, Prof Patrick HAUTECOEURb, Dr Cécile DONZEa
a GHICL, Hôpital Saint Philibert, Service MPRF, b GHICL, Hôpital Saint Philibert, Neurologie
Objective: Improvement of spatiotemporal gait parameters with Dalfampridine
Method: Retrospective study of data collected prospectively in patients with multiple sclerosis treated by Dalfampridine for gait disorders. Spatiotemporal gait parameters(1) were measured using a locometer at spontaneous and supported velocity after the establishment of Dalfambridine and after 14 days of treatment. In addition, a clinical examination and Time 25 Foot Walk Test (T25FW) were executed.
Results : 200 patients with Dalfampridine were evaluated between April 2013 and September 2014. 86 patients had exploitable gait analysis (age: 53.3 ± 9.5; median EDSS: 5.5 [max: 6.5; min: 4]). 41 (47.6%) were classified as responders (R) to the dalfampridine after improving their T25FWT of over 20% and 45 (52.3%) as non-responders (NR).
The Dalfampridine improved the spontaneous and supported walking velocity in the 2 groups (p<0.05). The cadence and stride length improved in the 2 groups independently of the velocity (p<0.05). On D14, the NR became asymmetrical (p <0.001) in spontaneous velocity. There was an inverse correlation between spontaneous walking velocity to D0 and the % of improvement T25FWT (r=-0.524; p<0.0001).
Discussion: Dalfampridine improves some spatiotemporal gait parameters in R as in NR but NR become asymmetrical at spontaneous velocity. The lack of improvement in voluntary motor function could explain this asymmetry. Spontaneous walking speed measured with locometer could be a predictive factor of response to Dalfampridine.
(1)Thoumie P, Lamotte D, Cantalloube S, et al. Motor determinants of gait in 100 ambulatory patients with multiple sclerosis. Multiple sclerosis (2005) 11 :485-491
Keywords : dalfampridine, spatiotemporal gait parameters, gait analysis, multiple slerosis