{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T04:31:59Z","timestamp":1789878719304,"version":"4.0.1"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2001,8]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:italic>\n                  <jats:bold>Background and Purpose<\/jats:bold>\n                <\/jats:italic>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            Spasticity is a frequently observed motor impairment that develops after stroke; it can cause pain and disability in those affected. The objective of the present study was to evaluate the safety and efficacy of tizanidine, a centrally acting \u03b1\n            <jats:sub>2<\/jats:sub>\n            -adrenergic agonist, in the treatment of stroke-related spasticity.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:italic>\n                  <jats:bold>Methods<\/jats:bold>\n                <\/jats:italic>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            Forty-seven patients, who were a minimum of 6 months poststroke and had significant spasticity, were studied at 4 centers. Tizanidine was administered in an open-label manner for 16 weeks, beginning at 2 mg\/d and slowly titrated to a maximum of 36 mg\/d. The Modified Ashworth Scale, muscle strength testing, functional assessments, and Pain and Functional Spasticity Questionnaires were administered at baseline and at 4, 8, 16, and 18 weeks (after 1 week off tizanidine).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:italic>\n                  <jats:bold>Results<\/jats:bold>\n                <\/jats:italic>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            Spasticity was significantly improved between baseline and week 16, with a decrease in total upper extremity Modified Ashworth Scale score of 2.80\u00b10.47 (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.0001). No decline in strength was noted. Treatment with tizanidine resulted in a significant improvement in pain intensity (\n            <jats:italic>P<\/jats:italic>\n            =0.0375), quality of life (\n            <jats:italic>P<\/jats:italic>\n            =0.0001), and physician assessment of disability (\n            <jats:italic>P<\/jats:italic>\n            =0.0001). The most frequent side effects were somnolence (62%) and dizziness (32%). No serious adverse events were considered to be drug related. Ten of 47 patients (21%) were able to reach the maximum daily dosage of 36 mg.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:italic>\n                  <jats:bold>Conclusions<\/jats:bold>\n                <\/jats:italic>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            Overall, the data suggest that tizanidine is safe and efficacious in the treatment of stroke-related spasticity, preserving muscle strength while reducing muscle tone and painful spasms in affected patients.\n          <\/jats:p>","DOI":"10.1161\/01.str.32.8.1841","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"1841-1846","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":56,"title":["Open-Label Dose-Titration Safety and Efficacy Study of Tizanidine Hydrochloride in the Treatment of Spasticity Associated With Chronic Stroke"],"prefix":"10.1161","volume":"32","author":[{"given":"David A.","family":"Gelber","sequence":"first","affiliation":[{"name":"From the Department of Neurology (D.A.G.), Southern Illinois University, Springfield, Ill; Departments of Neurology (D.C.G.) and Physical Medicine and Rehabilitation (M.R.), Wake Forest University, Winston-Salem, NC; Department of Neurology (A.D.), Washington University, St Louis, Mo; and Tampa Neurologic Associates (S.S.), Tampa, Fla."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Good","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (D.A.G.), Southern Illinois University, Springfield, Ill; Departments of Neurology (D.C.G.) and Physical Medicine and Rehabilitation (M.R.), Wake Forest University, Winston-Salem, NC; Department of Neurology (A.D.), Washington University, St Louis, Mo; and Tampa Neurologic Associates (S.S.), Tampa, Fla."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Dromerick","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (D.A.G.), Southern Illinois University, Springfield, Ill; Departments of Neurology (D.C.G.) and Physical Medicine and Rehabilitation (M.R.), Wake Forest University, Winston-Salem, NC; Department of Neurology (A.D.), Washington University, St Louis, Mo; and Tampa Neurologic Associates (S.S.), Tampa, Fla."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Sergay","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (D.A.G.), Southern Illinois University, Springfield, Ill; Departments of Neurology (D.C.G.) and Physical Medicine and Rehabilitation (M.R.), Wake Forest University, Winston-Salem, NC; Department of Neurology (A.D.), Washington University, St Louis, Mo; and Tampa Neurologic Associates (S.S.), Tampa, Fla."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Richardson","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (D.A.G.), Southern Illinois University, Springfield, Ill; Departments of Neurology (D.C.G.) and Physical Medicine and Rehabilitation (M.R.), Wake Forest University, Winston-Salem, NC; Department of Neurology (A.D.), Washington University, St Louis, Mo; and Tampa Neurologic Associates (S.S.), Tampa, Fla."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002727-199608000-00009"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-9651(18)30167-0"},{"key":"e_1_3_2_3_2","first-page":"16","volume":"1","year":"1999","unstructured":"Gelber DA, Jozefczyk P. 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