Article

OBJECTIVE: To investigate the effects of single doses of a selective serotonin
reuptake inhibitor (SSRI) on lower limb voluntary and reflex function in
individuals with chronic stroke. DESIGN: Double-blind, randomized,
placebo-controlled crossover trial. SETTING: Outpatient research setting.
PARTICIPANTS: Individuals
(N=10; 7 men; mean age +/- SD, 57+/-10y) with
poststroke hemiplegia of >1 year duration who completed all assessments.
INTERVENTIONS: Patients were assessed before and 5 hours after single-dose,
overencapsulated 10-mg doses of escitalopram (SSRI) or placebo, with 1 week
between conditions. MAIN OUTCOME MEASURES: Primary assessments included maximal
ankle and knee isometric strength, and velocity-dependent (30 degrees /s-120
degrees /s) plantarflexor stretch reflexes under passive conditions, and
separately during and after 3 superimposed maximal volitional drive to simulate
conditions of increased serotonin release. Secondary measures included clinical
measures of lower limb coordination and locomotion. RESULTS: SSRI administration
significantly increased stretch reflex torques at higher stretch velocities (eg,
90 degrees /s; P=.03), with reflexes at lower velocities enhanced by superimposed
voluntary drive (P=.02). No significant improvements were seen in volitional peak
torques or in clinical measures of lower limb function (lowest P=.10).
CONCLUSIONS: Increases in spasticity but not strength or lower limb function were
observed with single-dose SSRI administration in individuals with chronic stroke.
Further studies should evaluate whether repeated dosing of SSRIs, or as combined
with specific interventions, is required to elicit significant benefit of these
agents on lower limb function poststroke.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS