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Walking improvements with nabiximols in patients with multiple sclerosis

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Recently, nabiximols was approved as a treatment in MS spasticity. Data leading to approval and clinical use of nabiximols, although widely recognised, are based on subjective scales. Movement analysis procedures would obtain more detailed data about the impact on mobility. The aim of the study was to quantitatively assess the functional modification of gait patterns induced by nabiximols in MS. We evaluated three-dimensional gait analysis (spatial–temporal and kinematic) variation by means of one-way ANOVA. Twenty patients were enrolled—9 male and 11 female—with mean EDSS of 5.3 (SD ± 0.81) and mean reduction of numerical rating scale during nabiximols treatment of 1.88. The spatial–temporal parameters of gait revealed an increased speed (+15 %, p < 0.001), cadence (+6 %, p < 0.001) and stride length (+10 %, p < 0.001) after treatment. Regarding the kinematics data, the Gait Profile Score after treatment was reduced by 10 % (p < 0.001): Significant changes involved the pelvic area, hip rotation and knee flexion–extension. We found that nabiximols is able to improve the speed, cadence and stride length. Furthermore, the dynamics of the proximal segment of the legs and the knee movement results after treatment are closer to the physiologic values.

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Correspondence to G. Coghe.

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No conflict of interest exists regarding the present paper. Dr. Coghe received speaker fee from Teva, Almirall and Novartis and research grant from Novartis. Prof. Pau received speaker fee from Serono. Dr. Corona has nothing to disclose. Dr. Frau serves on scientific advisory boards for Biogen, received honoraria for speaking from Merck Serono and Teva and received a research grant from Serono. Dr. Fenu received honoraria for consultancy from Novartis and for speaking from Merck Serono and Teva, and received a research grant from Novartis. Dr. Lorefice received speaker fee from Teva and received a research grant from Serono Dr. Spinicci received speaker fee from Biogen. Dr Mamusa received speaker fee from Biogen. Dr. Musu received honoraria for consultancy and speaker fee from Biogen. Dr Massole received speaker fee from Biogen. Dr. Massa received speaker fee from Biogen. Professor Marrosu has received honoraria for consultancy or speaking from Bayer, Biogen-Idec, Novartis, Sanofi-Genzyme, Serono, Teva and Almirall. Prof. Cocco serves on scientific advisory boards and received honoraria for speaking from Bayer, Biogen, Merck Serono, Novartis, Sanofi-Genzyme and Teva.

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The study has been approved by the local ethic committee and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Coghe, G., Pau, M., Corona, F. et al. Walking improvements with nabiximols in patients with multiple sclerosis. J Neurol 262, 2472–2477 (2015).

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