Abstract Details

Title Quantitative Gait Analysis Techniques Detect Change Congruent with Patient Perceptions after Corticosteroid Treatment: A Pilot Study of Short-Term Change in Progressive MS

Topic MS and Related Diseases

Presentation(s) P04 - (-)

Poster/Presentation
Number 105

Objective

Background BACKGROUND: Measurement of MS-related neurological impairment relies heavily on ambulatory status. Gait is a complex neurological function and subjective patient-reported changes are often difficult to objectively confirm and quantify, especially over short periods of time. Reliable quantitative measures of gait status could enhance the validity of clinical trials of both disease-modifying and symptomatic therapies. Pulse corticosteroid therapy has been used to improve or stabilize gait dysfunction in progressive MS, but it is often difficult to detect objective clinical improvement, even in patients who report subjective improvement.

Design/Methods DESIGN/METHODS: We measured gait status in 5 patients with primary or secondary progressive MS before, immediatelyafter (3-7 days), and 3 months after corticosteroid administration (1g/d x 5d) with the following outcome measures: patient perception of gait change, standard neurological measures of gait (Expanded Disability Status Scale (EDSS), 25-foot timed gait, Ambulation Index (AI)), and multivariable gait laboratory assessment (temporal-distance measures including gait velocity and stride length) over a course that included several turns.

Results RESULTS: After corticosteroid administration, EDSS and AI scores and clinic-based 25-foot walk times did not change significantly. However, three patients reported subjective improvement, 1 reported mild worsening, and 1 reported no change in gait function after treatment. Gait laboratory assessment showed improvement in gait velocity and stride length in the four patients who subjectively remained stable or improved while improvement was not detected in the patient who subjectively worsened.

Conclusions CONCLUSIONS: Gait laboratory analysis can detect and quantify change in gait function after corticosteroid treatment that is congruent with patients' subjective experience. Further evaluation of quantitative gait methods is needed to identify variables measureable in clinical settings and predictive of long-term change.

Authors/Disclosures
Melissa M. Cortez, DO (University of Utah Neurology) PRESENTER	The institution of Dr. Cortez has received research support from NIH NINDS. The institution of Dr. Cortez has received research support from Dysautonomia International. Dr. Cortez has received personal compensation in the range of $500-$4,999 for serving as a Content Expert, Reviewer, DSMB with NIH RECOVER project.
Stephen Wanaski, PhD (Paragon Biosciences)	Dr. Wanaski has received personal compensation for serving as an employee of Paragon Biosciences. Dr. Wanaski has or had stock in Paragon Biosciences.Dr. Wanaski has or had stock in Emalex Biosciences.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Dean M. Wingerchuk, MD, FAAN (Mayo Clinic)	Dr. Wingerchuk has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics. Dr. Wingerchuk has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Wingerchuk has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Wingerchuk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Wingerchuk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Meyer Squibb. Dr. Wingerchuk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Wingerchuk has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca. Dr. Wingerchuk has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Wingerchuk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abcuro. Dr. Wingerchuk has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wolters Kluwers.

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