Comparison of the effect of baclofen and transcutaneous electrical nerve stimulation for the treatment of spasticity in multiple sclerosis

Abstract

Objective: The aim of this study was to compare the relative efficacy of baclofen and self-applied transcutaneous electrical nerve stimulation (TENS) for the treatment of spasticity in the lower extremities in multiple sclerosis (MS).

Methods: A randomized controlled clinical trial was conducted from September 2010 to June 2011. Fifty-two patients with MS presenting muscle spasm in the leg at 20–50 years of age were randomly allocated to receive a four-week treatment course of either baclofen (10 mg twice daily, increasing over three weeks to 25 mg) or self-applied TENS. Response to treatment was assessed at four weeks after commencement of the intervention by modified Ashworth scale (MAS).

Results: Spasticity decreased in both groups. Of the 26 people treated with TENS, the mean (standard deviation (SD)) MAS decreased from 1·77 (0·29) at baseline to 0·73 (0·70) at the four-week follow-up (P < 0·001). Correspondingly, in the 26 people treated with baclofen, the mean (SD) MAS decreased from 1·73 (0·38) to 1·15 (0·63) (P < 0·001). The mean difference in MAS score at the four-week follow-up was significantly lower in the TENS group than the baclofen group (mean difference −0·42; 95% CI, −0·79, −0·05; P < 0·05).

Discussion: This study demonstrates that both baclofen and TENS can be effective in reducing MS-related spasticity. The mean MAS score was significantly lower in the TENS group. However given the side-effect profile of baclofen, TENS may have some benefits over baclofen.

Keywords:

• Baclofen
• Efficacy
• Transcutaneous electrical nerve stimulation
• Muscle spasticity
• Modified Ashworth scale
• Multiple sclerosis
• Clinical trial

All authors vouch for the veracity and completeness of the reported data, and all authors contributed to various aspects of the trial design, data gathering and analysis, and preparation of the manuscript. This work was partially supported by funds from Isfahan University of Medical Sciences, Iran. This research was performed as a part of the academic activity of the university.