Prolonged-release fampridine in multiple sclerosis: Improved ambulation effected by changes in walking pattern

Background:Prolonged-release fampridine (PR-fampridine, 4-aminopyridine) increases walking speed in the timed 25-foot walk test (T25FW) in some patients (timed-walk responders) with multiple sclerosis (MS).Objective:To explore the effects of PR-fampridine on different aspects of walking function and to identify associated gait modifications in subjects with MS.Methods:In this prospective, randomized, placebo-controlled, double-blind, phase II study (FAMPKIN; clinicaltrials.gov, NCT01576354), subjects received a 6-week course of oral placebo or PR-fampridine treatment (10 mg, twice daily) before crossing over. Using 3D-motion-analysis, kinematic and kinetic parameters were assessed during treadmill walking (primary endpoint). Clinical outcome measures included T25FW, 6-minute walk test (6MWT), and balance scales. Physical activity in everyday life was measured with an accelerometer device.Results:Data from 55 patients were suitable for analysis. Seventeen subjects were timed-walk responders under PR-fampri...