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Home > MSAA Publications > The Motivator > The Motivator: Winter/Spring 2009 > Cover Story - Symptom Management Update > SECTION 3: WEAKNESS
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< SECTION 2: SPASTICITY - Home - SECTION 4: BALANCE >

SECTION 3: WEAKNESS

Weakness is a common symptom in MS, resulting from the demyelination of neurons in the brain and spinal cord that control the muscles. It most commonly affects those muscles involved in walking.

NON-PHARMACOLOGIC MANAGEMENT

Exercise

An exercise program that involves extensive work with weights is not generally effective in reducing weakness, although a general exercise program prescribed by a physical therapist or other healthcare provider can lessen weakness by improving your overall level of conditioning. It should incorporate passive exercises that include range of motion and stretching, as well as active exercises tailored to the individual. These often include progressive-resistance exercises and aerobic exercises to whatever extent safely and comfortably possible for the individual patient.

PHARMACOLOGIC MANAGEMENT

Drugs that reduce spasticity and fatigue may also help to reduce weakness.

Fampridine SR®(long-acting fampridine, 4-aminopyridine)

When and if it is approved by the FDA, this oral medication has been studied at a dose of 10 mg, once to twice daily.

This drug may improve communication between damaged neurons to increase neurologic function, as indicated by an improvement in walking speed and strength.

A 14-week, Phase III, multi-center trial in people with MS found that approximately 35 percent of the treated group showed consistent improvement in walking speed, versus just over 8 percent of the placebo group. The treated group also experienced an increase in strength. Patients who responded to the drug also reported feeling less disabled in activities that required mobility.

The favorable results of a second phase III study (sponsored by Acorda Therapeutics), which evaluated the safety, tolerability, and activity in individuals who participated in the original trial, were presented in the fall of 2008. An FDA application was submitted in January 2009, and is now being reviewed for possible approval.

Side effects included dizziness, falls, back pain, insomnia, fatigue, nausea, and balance problems.

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Last Updated on Friday, 10 May 2013 10:33