{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T01:44:49Z","timestamp":1775526289668,"version":"3.50.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"1193","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100011698","name":"Junta de Comunidades de Castilla-La Mancha","doi-asserted-by":"publisher","award":["2023-PREJCCM-000062"],"award-info":[{"award-number":["2023-PREJCCM-000062"]}],"id":[{"id":"10.13039\/501100011698","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Castilla-La Mancha Regional Government\/FEDER, UE","award":["SBPLY\/21\/180501\/000186"],"award-info":[{"award-number":["SBPLY\/21\/180501\/000186"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Spasticity, a prevalent manifestation of various neurological conditions, significantly impacts the quality of life of patients. Research on the effects of oral drugs on spasticity has produced controversial results. Thus, the aim of this network meta-analysis was to compare the efficacy of oral drugs for improving spasticity in patients with different etiologies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched four different databases from their inception to 30 November 2023. A network meta-analysis using a frequentist perspective was conducted to assess the effects of different oral drugs on spasticity, evaluated by the modified Ashworth scale.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Our findings showed that, in a frequentist network meta-analysis, eperisone, diazepam, and baclofen had significantly greater spasticity, as measured by the modified Ashworth scale, than did the placebo (MD: \u22120.80; 95% CIs: \u22121.42, \u22120.18; MD: \u22120.68; 95% CIs: \u22121.28, \u22120.09; MD: \u22120.58; 95% CIs: \u22121.11, \u22120.06, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In summary, our study confirmed that eperisone, diazepam, and baclofen could be effective approaches for reducing spasticity of different etiologies and could be useful approaches for improving patient quality of life.<\/jats:p>\n                  <jats:p>Key messages What is already known on this topic: The impact of oral drugs, such as baclofen, gabapentin, tizanidine, and dantrolene, in the treatment of spasticity has been documented. What this study adds: This study determines which of the oral drugs aimed at treating spasticity is the most effective across different etiologies. How this study might affect research, practice, or policy: This study suggests tailored treatment strategies for spasticity based on its etiology.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/postmj\/qgae126","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T22:07:33Z","timestamp":1727734053000},"page":"212-218","source":"Crossref","is-referenced-by-count":2,"title":["Comparative effect of oral drugs in improving spasticity of different etiology: a network meta-analysis"],"prefix":"10.1093","volume":"101","author":[{"given":"Iris","family":"Otero-Luis","sequence":"first","affiliation":[{"name":"CarVasCare Research Group (2023-GRIN-34459) , Facultad de Enfermer\u00eda de Cuenca, Universidad de Castilla-La Mancha, 16002 Cuenca ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arturo","family":"Mart\u00ednez-Rodrigo","sequence":"additional","affiliation":[{"name":"Informatics Systems Department, University of Castilla-La Mancha , Cuenca ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iv\u00e1n","family":"Cavero-Redondo","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad Aut\u00f3noma de Chile , Talca 3460000 ,","place":["Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nerea","family":"Moreno-Herr\u00e1iz","sequence":"additional","affiliation":[{"name":"CarVasCare Research Group (2023-GRIN-34459) , Facultad de Enfermer\u00eda de Cuenca, Universidad de Castilla-La Mancha, 16002 Cuenca ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"L\u00f3pez-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Castilla-La Mancha Health Services, SESCAM, Hospital of Cuenca , C\/Hermandad de Donantes de Sangre, 1, 16002, Cuenca ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Saz-Lara","sequence":"additional","affiliation":[{"name":"CarVasCare Research Group (2023-GRIN-34459) , Facultad de Enfermer\u00eda de Cuenca, Universidad de Castilla-La Mancha, 16002 Cuenca ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"2025022013484610500_ref1","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1136\/practneurol-2011-000155","article-title":"Spasticity: pathophysiology, evaluation and management","volume":"12","author":"Kheder","year":"2012","journal-title":"Pract Neurol"},{"key":"2025022013484610500_ref2","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.hcl.2018.06.001","article-title":"Common etiologies of upper extremity spasticity","volume":"34","author":"Angulo-Parker","year":"2018","journal-title":"Hand Clin"},{"key":"2025022013484610500_ref3","doi-asserted-by":"publisher","first-page":"487","DOI":"10.2165\/00003495-200059030-00006","article-title":"Drugs used to treat spasticity","volume":"59","author":"Kita","year":"2000","journal-title":"Drugs"},{"key":"2025022013484610500_ref4","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1002\/mus.27792","article-title":"Spasticity evaluation and management tools","volume":"67","author":"Howard","year":"2023","journal-title":"Muscle Nerve"},{"key":"2025022013484610500_ref5","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1038\/nrd3502","article-title":"Beyond classical benzodiazepines: novel therapeutic potential of GABAA receptor subtypes","volume":"10","author":"Rudolph","year":"2011","journal-title":"Nat Rev Drug Discov"},{"key":"2025022013484610500_ref6","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.1177\/1352458516643600","article-title":"Pharmacological management of spasticity in multiple sclerosis: systematic review and consensus paper","volume":"22","author":"Otero-Romero","year":"2016","journal-title":"Mult Scler"},{"key":"2025022013484610500_ref7","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1016\/j.apmr.2013.10.023","article-title":"Efficacy of coupling repetitive transcranial magnetic stimulation and physical therapy to reduce upper-limb spasticity in patients with stroke: a randomized controlled trial","volume":"95","author":"Galv\u00e3o","year":"2014","journal-title":"Arch Phys Med Rehabil"},{"key":"2025022013484610500_ref8","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1186\/1741-7015-11-159","article-title":"Is network meta-analysis as valid as standard pairwise meta-analysis? 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