Antispasmodic medications may be associated with reduced recovery during inpatient rehabilitation after traumatic spinal cord injury

The Journal of Spinal Cord Medicine, 2018 · DOI: 10.1080/10790268.2016.1245010 · Published: January 1, 2018

Spinal Cord Injury Pharmacology Rehabilitation

Simple Explanation

This study investigates if antispasmodic drugs affect recovery after traumatic spinal cord injury (SCI). It looks at neurological and functional outcomes within the first year after the injury. The research involved analyzing data from six rehabilitation centers, comparing patients who used antispasmodic medication for at least five days during their inpatient rehabilitation with those who did not. The study found that patients who received antispasmodic medications showed decreased functional recovery at discharge from inpatient rehabilitation. However, at the one-year follow-up, this difference was not significant.

Study Duration

2007 to December 2009

Participants

1,259 patients with traumatic SCI

Evidence Level

Not specified

Key Findings

1
Patients receiving antispasmodic medications had significantly lower Rasch-transformed motor FIM scores at discharge compared to those not receiving the medications.
2
At one-year follow-up, there were no significant differences in outcomes between patients who were on or off antispasmodic medications.
3
Multivariate regression analysis showed that receiving antispasmodic medication significantly contributed to discharge motor FIM outcome.

Research Summary

This study examined the association between antispasmodic medication use and neurological and functional outcomes in patients undergoing inpatient rehabilitation after traumatic SCI. The results indicated that patients who received antispasmodic medications had lower motor FIM scores at discharge, suggesting a potential negative impact on functional recovery during inpatient rehabilitation. While the initial findings suggest a correlation between antispasmodic use and reduced recovery, the study emphasizes the need for randomized prospective studies to confirm these effects and determine causality.

Practical Implications

Clinical Practice

Clinicians should carefully consider the potential impact of antispasmodic medications on functional recovery when prescribing them to patients with acute traumatic SCI during inpatient rehabilitation.

Further Research

Future research should focus on conducting randomized controlled trials to directly assess the effects of antispasmodic medications on neurological and functional outcomes after SCI.

Treatment Strategies

Rehabilitation programs may need to emphasize activity-based therapy and minimize reliance on pharmacological neural inhibitors to enhance recovery after SCI, where appropriate.

Study Limitations

1
The findings are correlative, and causation cannot be inferred.
2
Spasticity was not measured with any standard tool, and indications for prescribing medications were not recorded.
3
Retrospective comparison introduces bias based on baseline differences between the groups.

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