Quantitative Assessment of the Effect of Tizanidine on Spasticity in Stroke Patients

ABSTRACT

OBJECTIVE: The aims of this study were to evaluate quantitatively the effect of tizanidine on spasticity reduction and to evaluate the effective and tolerable dosage of it in stroke patients. METHOD: A prospective, randomized controlled study was carried out. 24 stroke patients were included and randomly assigned to a control and experimental group. In experimental group, tizanidine was medicated from starting dose of 3 mg/day and titrated up by 3 mg/day increments every 3 days to a maximal dose of 15 mg/day. In both group assessment of spasticity was done by clinical and biomechanical-neurophysiological methods one day before medication (baseline), on 9th and 15th days after medication. Biomechenical-neurophysiological assessment was done through isokinetic dynamometer and BIOPAC system. RESULTS: In control group, no significant changes were found in the degree of spasticity between each assessment. In experimental group, most of the parameters that determine the degree of spasticity revealed the significant reduction of spasticity on the post-medication assessment compared with the baseline assessment (p<0.01). The degree of spasticity reduction was increased with the increase of dosage. The incidence of adverse effect was also increased with the increase of dosage, but tolerable within the dosage of 15 mg/day. CONCLUSION: Tizanidine was effective in reducing spasticity in stroke patients. Its efficacy and adverse effects were dosage-related.