title: Comparing the efficacy of botulinum toxin with tizanidine in upper limb post stroke spasticity.
abstract: BACKGROUND
  This study evaluated the efficacy of focal intramuscular injection of botulinum (BoNT) toxin type A in comparison with oral tizanidine (TZD) in treatment of post-stroke upper limb spasticity.
  
  
  METHODS
  This was a double-blinded randomized clinical trial that recruited 68 patients with post-stroke upper limb spasticity. Thirty-four patients received BoNT (Dysport(®)) injections in affected muscles of upper limb at the baseline and week 12. Thirty-four patients were treated with tizanidine (Sirdalude) by gradual increase in dosage of 2mg/week to reach maximum 24mg at week 12. Modified Ashworth Scale (MAS) and Action Research Arm Test (ARAT) were evaluated at the baseline, week 12 and week 24 for all the participants.
  
  
  RESULTS
  The mean score of MAS reduced from 3.32 and 3.13 at baseline to 1.79 and 1.56 at week 24 on elbow and wrist joints, respectively (P < 0.01). However, there were only reductions from 2.79 and 2.77 to 2.32 and 2.31 (P < 0.001) in TZD group. ARAT increased from 1.79 to 10.97 (P < 0.001) in BoNT group. ARAT increased from 11.08 to 11.35 in TZD group (P = 0.026).
  
  
  CONCLUSIONS
  BoNT injection was safe and effective in reducing post-stroke upper extremity spasticity in comparison with TZD.
authors.affiliation: Associate Professor, Department of Neurology, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Yazdchi
authors.forename: Zahra
authors.initials: Z
authors.lastname: Ghasemi
authors.forename: Hanieh
authors.initials: H
authors.lastname: Moshayedi
authors.forename: Reza
authors.initials: R
authors.lastname: Rikhtegar
authors.forename: Somayeh
authors.initials: S
authors.lastname: Mostafayi
authors.forename: Hale
authors.initials: H
authors.lastname: Mikailee
authors.forename: Safa
authors.initials: S
authors.lastname: Najmi
keywords: Action Research Arm Test; Dysport; Modified Ashworth Scores; Post-Stroke Upper Limb Spasticity; Tizanidine