Dalfampridine improves walking speed, walking endurance, and community participation in veterans with multiple sclerosis

A longitudinal cohort study

Michelle Cameron, Mary Fitzpatrick, Shannon Overs, Charles Murchison, Jane Manning, Ruth Whitham

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: In short-term trials, dalfampridine extended release (ER) improves walking in people with multiple sclerosis (MS). The tolerability and effects of dalfampridine-ER in clinical practice have not been reported. Objectives: The objective of this paper is to determine the clinical tolerability and effects of dalfampridine on walking and community participation. Methods: All patients at the Portland VA Medical Center prescribed dalfampridine-ER over one year completed the Timed 25-Foot Walk (T25FW), Multiple Sclerosis Walking Scale-12 (MSWS-12), Two-Minute Timed Walk (2MTW), and Community Integration Questionnaire (CIQ) at baseline and follow-up clinic visits. Ongoing use and measures over one year were analyzed. Results: A total of 39 patients (mean age 56.5 years, mean disease duration 19.5 years, 82% male, 38% relapsing- remitting MS, 62% progressive MS) were prescribed dalfampridine-ER. Twenty-four (62%) continued to take dalfampridine- ER. At initial follow-up, all measures improved significantly from baseline (T25FW: -2.7 s, p = 0.004; 2MTW: 41 feet (ft), p = 0.002; MSWS12: -11, p <0.001; CIQ: 1.2, p = 0.003). At one year, walking endurance and self-perceived walking were still significantly improved (2MTW: 33 ft, p = 0.03; MSWS-12: 5.9, p = 0.007). Conclusions: Dalfampridine-ER was associated with short-term improvements in walking speed and community participation, and sustained improvements in walking endurance and self-perceived impact of MS on walking for one year. Our study supports the utility of this medication in late MS.

Original languageEnglish (US)
Pages (from-to)733-738
Number of pages6
JournalMultiple Sclerosis
Volume20
Issue number6
DOIs
StatePublished - 2014

Fingerprint

Veterans
Multiple Sclerosis
Walking
Longitudinal Studies
Cohort Studies
Community Integration
Relapsing-Remitting Multiple Sclerosis
Walking Speed
Community Participation
Ambulatory Care

Keywords

  • cohort studies
  • cost effectiveness/economic
  • dalfampridine
  • Multiple sclerosis
  • walking

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Medicine(all)

Cite this

Dalfampridine improves walking speed, walking endurance, and community participation in veterans with multiple sclerosis : A longitudinal cohort study. / Cameron, Michelle; Fitzpatrick, Mary; Overs, Shannon; Murchison, Charles; Manning, Jane; Whitham, Ruth.

In: Multiple Sclerosis, Vol. 20, No. 6, 2014, p. 733-738.

Research output: Contribution to journalArticle

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title = "Dalfampridine improves walking speed, walking endurance, and community participation in veterans with multiple sclerosis: A longitudinal cohort study",
abstract = "Background: In short-term trials, dalfampridine extended release (ER) improves walking in people with multiple sclerosis (MS). The tolerability and effects of dalfampridine-ER in clinical practice have not been reported. Objectives: The objective of this paper is to determine the clinical tolerability and effects of dalfampridine on walking and community participation. Methods: All patients at the Portland VA Medical Center prescribed dalfampridine-ER over one year completed the Timed 25-Foot Walk (T25FW), Multiple Sclerosis Walking Scale-12 (MSWS-12), Two-Minute Timed Walk (2MTW), and Community Integration Questionnaire (CIQ) at baseline and follow-up clinic visits. Ongoing use and measures over one year were analyzed. Results: A total of 39 patients (mean age 56.5 years, mean disease duration 19.5 years, 82{\%} male, 38{\%} relapsing- remitting MS, 62{\%} progressive MS) were prescribed dalfampridine-ER. Twenty-four (62{\%}) continued to take dalfampridine- ER. At initial follow-up, all measures improved significantly from baseline (T25FW: -2.7 s, p = 0.004; 2MTW: 41 feet (ft), p = 0.002; MSWS12: -11, p <0.001; CIQ: 1.2, p = 0.003). At one year, walking endurance and self-perceived walking were still significantly improved (2MTW: 33 ft, p = 0.03; MSWS-12: 5.9, p = 0.007). Conclusions: Dalfampridine-ER was associated with short-term improvements in walking speed and community participation, and sustained improvements in walking endurance and self-perceived impact of MS on walking for one year. Our study supports the utility of this medication in late MS.",
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AB - Background: In short-term trials, dalfampridine extended release (ER) improves walking in people with multiple sclerosis (MS). The tolerability and effects of dalfampridine-ER in clinical practice have not been reported. Objectives: The objective of this paper is to determine the clinical tolerability and effects of dalfampridine on walking and community participation. Methods: All patients at the Portland VA Medical Center prescribed dalfampridine-ER over one year completed the Timed 25-Foot Walk (T25FW), Multiple Sclerosis Walking Scale-12 (MSWS-12), Two-Minute Timed Walk (2MTW), and Community Integration Questionnaire (CIQ) at baseline and follow-up clinic visits. Ongoing use and measures over one year were analyzed. Results: A total of 39 patients (mean age 56.5 years, mean disease duration 19.5 years, 82% male, 38% relapsing- remitting MS, 62% progressive MS) were prescribed dalfampridine-ER. Twenty-four (62%) continued to take dalfampridine- ER. At initial follow-up, all measures improved significantly from baseline (T25FW: -2.7 s, p = 0.004; 2MTW: 41 feet (ft), p = 0.002; MSWS12: -11, p <0.001; CIQ: 1.2, p = 0.003). At one year, walking endurance and self-perceived walking were still significantly improved (2MTW: 33 ft, p = 0.03; MSWS-12: 5.9, p = 0.007). Conclusions: Dalfampridine-ER was associated with short-term improvements in walking speed and community participation, and sustained improvements in walking endurance and self-perceived impact of MS on walking for one year. Our study supports the utility of this medication in late MS.

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