Document Detail


Reduction of spastic hypertonia in patients with spinal cord injury: a double-blind comparison of intravenous orphenadrine citrate and placebo.
MedLine Citation:
PMID:  7605186     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Spasticity is one of the major problems affecting the outcome of rehabilitation in paraplegic patients. Orphenadrine citrate possesses an effective muscle relaxant action in many pathologies. Nevertheless, despite a recognized central site of action, no controlled data are available on its use in the treatment of spastic hypertonia in patients with spinal cord injuries. Therefore, the effect of intravenous administration of 60mg of orphenadrine citrate versus placebo on spastic hypertonia after spinal cord injury was studied in 11 patients. The threshold of the flexion reflex of the lower limb was studied as a neurophysiological correlate of spastic hypertonia. Clinical assessment was made using the Ashworth Spasticity Scale. The threshold, expressed in mAmp, was studied for 60 minutes after the treatment. A significant difference was found using the active drug compared with placebo (p < 0.0001). In 9 patients, the reduction of the abnormal flexion responses after orphenadrine appeared to begin only after 30 minutes. In one patient the onset of the therapeutic effect was early but weak. One patient with severe spastic hypertonia leading to triple flexion when the limb was manipulated did not gain any relief with orphenadrine. The clinical and neurophysiological results suggest an efficacy of orphenadrine citrate in the control of spastic hypertonia in paraplegics. This could be relevant in the rehabilitation strategy, although further studies are needed on the duration of its action.
Authors:
R Casale; C J Glynn; M Buonocore
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  76     ISSN:  0003-9993     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  1995 Jul 
Date Detail:
Created Date:  1995-08-10     Completed Date:  1995-08-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  660-5     Citation Subset:  AIM; IM    
Affiliation:
Foundation Clinica del Lavoro, Rehabilitation Center of Montescano, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cross-Over Studies
Double-Blind Method
Female
Humans
Injections, Intravenous
Leg / physiopathology
Male
Muscle Hypertonia / drug therapy*,  physiopathology
Muscle Spasticity / drug therapy,  physiopathology
Orphenadrine / administration & dosage,  therapeutic use*
Placebos
Spinal Cord Injuries / physiopathology*
Chemical
Reg. No./Substance:
0/Placebos; 83-98-7/Orphenadrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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