Case Report: Combining Dalfampridine with Multicomponent Exercise and Gait Training in a Person with Multiple Sclerosis

Plummer, Prudence; Bohling, Corinne J.; Nickles, L. Ellese; Williams, Alexander; Thomas, Amy; Marković-Pleše, Silva; Giesser, Barbara

doi:10.7224/1537-2073.2017-074

Cited by 2 publications

(3 citation statements)

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“…Participants taking dalfampridine took 10 mg doses every 12 h per physician prescription. The physical therapy intervention has been described elsewhere ( 11 ) but critical components are detailed here.…”

Section: Methodsmentioning

confidence: 99%

“…During dual-task training, participants performed cognitive tasks while practicing gait and balance activities. Several different cognitive activities were used with two different activities assigned to each session to ensure all participants practiced a range of dual-tasks ( 11 ).…”

Section: Methodsmentioning

confidence: 99%

“…Although the precision of effect size estimates for gait training are currently limited by very small rehabilitation studies ( 4 ), interventions with promising effect sizes have included conventional gait training ( 6 ) as well as robot-assisted and treadmill-based gait training ( 5 , 9 , 10 ). Further, it is possible that combining physical therapy with dalfampridine may increase the effect size of dalfampridine on gait speed and the proportion of patients who experience a clinically meaningful treatment effect ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

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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

Plummer

Marković-Pleše

Giesser

2022

Front. Rehabilit. Sci.

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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.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%