PT researcher assesses effectiveness of combined treatment plan for gait rehabilitation for MS patients

Dr. Prudence Plummer, PhD, PT, an assistant professor in the Division of Physical Therapy, has received a $40,000 grant from the National Multiple Sclerosis Society for a pilot study to look at the combined effects of a drug and physical therapy for gait rehabilitation in multiple sclerosis (MS).

Read more about Dr. Plummer and team’s research below.

How will this research address gait rehabilitation for people diagnosed with MS?

People with MS frequently experience difficulties with walking, due to nervous system damage. Traditionally, physical therapy (gait rehabilitation) and medication (pharmacological management) have been sepa­rate approaches for the treatment of walking impairments in people with MS. Dalfampridine, also known as the “walking pill,” has been developed to help improve walking impairments for patients with MS. The drug has been shown to have prom­ising effects for approximately 40 percent of those who take it.

Dr. Plummer and team’s research will provide insight as to whether providing physical therapy to people who are pre­scribed Dalfampridine can further improve walking impair­ments. They will assess whether the combined treatment produces better outcomes in walking tasks and cognition as compared to medi­cation and no physical therapy.

How will the team assess the effectiveness of the combined treatment plan?

Dr. Plummer, as principal investigator, along with co-investigators Dr. Silva Markovic-Plese, PhD, asso­ciate professor of Neurology, and Dr. Barbara Giesser, professor of neurology at UCLA, will recruit10 MS patients who have been pre­scribed the walking pill by their physician. Researchers will assess walking and cognition before participants take their first dose of the medication and after six weeks. During this time, participants will not receive physical therapy.

Following the initial six weeks of treatment with dalfampridine only, half of the participants will be assigned to receive six weeks (18 sessions) of physical therapy gait training while continuing to take their medication; the other half will continue to take their medication without receiving gait training.To control for possible effects of time and attention, the control group will attend the same number of sessions with a physical therapist but instead of receiving active physical therapy, they will receive wellness education. After the combined treatment period, Dr. Plummer’s team will compare changes in walking and in mental processing speed.  A follow-up will also be conducted six weeks later.

What are the expected outcomes of this research?

This research will provide important preliminary findings on the efficacy of combining physical and pharmacological therapy for improving walking in people with MS. A larger study will be needed to determine whether the combined treatment is more effective than either treatment alone. It is hoped that this research will allow future optimization of treatment for improving walking impair­ments and quality of life for people living with MS. The research also will provide a better understanding of the extent to which the walking pill can improve other functional tasks, such as mental processing speed and walking in more realistic conditions.

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