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Effect of antispastic drugs on motor reflexes and voluntary muscle contraction in incomplete spinal cord injury. Arch Phys Med Rehabil 2014 Apr;95(4):622-32

Date

11/26/2013

Pubmed ID

24269485

DOI

10.1016/j.apmr.2013.11.001

Abstract

OBJECTIVE: To investigate the effects of antispastic drugs baclofen and tizanidine on reflexes and volitional tasks.

DESIGN: Double-blind, placebo-controlled, crossover, before-after trial, pilot study.

SETTING: Research laboratory in a rehabilitation hospital.

PARTICIPANTS: Men with chronic (>6mo) motor incomplete spinal cord injury (N=10) were recruited for the study.

INTERVENTIONS: Tizanidine, baclofen, and placebo were tested in this study. Agents were tested in separate experimental sessions separated by >1 week.

MAIN OUTCOME MEASURES: Reflex and strength were measured before and after the administration of a single dose of each intervention agent. Electromyographic and joint torque data were collected during assessments of plantar flexor stretch reflexes, maximum contraction during motor-assisted isokinetic movements, and maximum isometric knee extension and flexion.

RESULTS: Reduced stretch reflex activity was observed after the administration of either tizanidine or baclofen. We observed that tizanidine had a stronger inhibitory effect on knee extensors and plantar flexors whereas baclofen had a stronger inhibitory effect on the knee flexors. The effects of these drugs on strength during isometric and isokinetic tasks varied across participants, without a consistent reduction in torque output despite decreased electromyographic activity.

CONCLUSIONS: These results suggest that antispastic drugs are effective in reducing stretch reflexes without substantially reducing volitional torque. Differential effects of tizanidine and baclofen on reflexes of flexors and extensors warrant further investigation into patient-specific management of antispastic drugs.

Author List

Chu VW, Hornby TG, Schmit BD

Author

Brian Schmit PhD Professor in the Biomedical Engineering department at Marquette University




MESH terms used to index this publication - Major topics in bold

Adult
Baclofen
Clonidine
Cross-Over Studies
Double-Blind Method
Electromyography
Humans
Isometric Contraction
Lower Extremity
Male
Middle Aged
Muscle Relaxants, Central
Muscle Strength
Pilot Projects
Reflex, Stretch
Spinal Cord Injuries
Torque