Effect Of Transdermal Baclofen Iontophoresis With Passive Stretching On Spasticity In Stroke Survivors

Abstract

Stroke is an important disability in the world. Stroke survivor s presents newlinewith complex physical, mental and social issues. Spasticity is a key clinical entity, newlinewhich has to be addressed. Various pharmacological drugs available in market to newlinereduce spasticity which are administered through various routes like intrathecal, newlineoral and intramuscular , but its adverse effects on gastrointestinal system proves newlinecostly and hampers physiotherapy rehabilitation. Hence different route of drug newlineadministration like transdermal iontophoresis along with physiotherapy newlineinterventions can bring a change in spasticity and physiotherapy outcome or not? newlineObjective newlineTo determine the effect of transdermal baclofen Iontophoresis with passive newlinestretching on spasticity and lower limb function in stroke survivors. newlineStudy Design newlineSingle blinded randomised controlled trial. newlineSubjects newline100 subjects were recruited for this study including both males and newlinefemales. The subjects were allocated to any of the two groups randomly. newlineMethods newlineSubjects with Spastic hemiplegia were divided into two groups. Prior to newlineintervention spasticity, lower limb function, pain assessed using modified newlineashworth scale, fugl Meyer assessment and visual analog scale respectively. newlinevii newlineExperimental group received transdermal baclofen iontophoresis for 15 newlineminutes four times a week for 4 weeks and 10 repetitions of passive stretching newlineof calf muscles. The spasticity, lower limb function and pain were re-graded post newlineintervention after every 4 sessions (every week).The follow up measures were newlinetaken after 3 months. The Control group received 10 repetitions of passive newlinestretching. newlineResults newlineThe spasticity and pain score were found to be reduced and lower limb newlinefunction score increased. Spasticity was evaluated using MAS. Pre to post Mas newlinedifference for experimental group showed to be statistically significant with p newlinevalue lt 0.0001 on 2nd , 3rd , 4th week and also after 3 months after intervention newlinewhereas 1st week p value was not significant with p value of 0.762. Lower limb newlinefunction was assessed by FMA. Pre to post FMA difference for experimental newlinegroup showed to be statistically significant with p value less than 0.0001 on 2nd , newline3rd , 4th week and also after 3 months after intervention whereas 1st week p value newlinewas not significant with p value of 0.398.Pain score was assessed by VAS. Pre to newlinepost VAS difference for experimental group showed to be statistically significant newlinewith p value of less than 0.0001 on 2nd , 3rd , 4th week and also after 3 months newlineafter intervention whereas 1st week p value was not significant with p value of newline0.647. newlineConclusion newlineThis suggests that transdermal administration with baclofen with physical newlinetherapy intervention significantly reduced spasticity, improved lower limb function newlineand reduced pain and which was consistently maintained even after 3 months newlinefrom the intervention