TY - CHAP M1 - Book, Section TI - Skeletal Muscle Relaxants A1 - Jobst, Erin E. A1 - Panus, Peter C. A1 - Kruidering-Hall, Marieke PY - 2020 T2 - Pharmacology for the Physical Therapist, 2e AB - CASE STUDYS.E. is a 54-year-old man with relapsing remitting multiple sclerosis (RR-MS) diagnosed 12 years ago. He lives in a single-level home with his wife and two teenage children. S.E. is able to perform stand-pivot transfers independently and can sometimes ambulate limited household distances with a four-wheeled walker. His major mode of mobility is an electric wheelchair; however, he states that he would like to stand and walk more if possible. He is self-employed as an architect and works approximately 30 hours per week. S.E. is slightly overweight (BMI 25 kg/m2) but has no other comorbidities. He is currently taking oral baclofen and tizanidine for bilateral lower extremity spasticity. S.E. was referred to physical therapy for evaluation of his ambulatory skills and assessment of assistive devices. Upon initial evaluation, the patient had limited movement and volitional activity of his lower extremities, but upper extremity strength was normal. He has significant functional strength, as he is able to lift himself into and out of his vehicle daily. The physical therapist initially fitted S.E. with custom molded ankle-foot orthoses and began a neuromuscular re-education program to improve his ambulatory skills. S.E. had significant spasticity in his lower extremities, which was exacerbated with transfers and lower extremity weightbearing activity. Because spasticity was limiting his ability to make functional improvements, S.E.’s baclofen was increased to a maximum tolerated oral dose along with a slight increase in his oral dose of tizanidine. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessphysiotherapy.mhmedical.com/content.aspx?aid=1192819362 ER -