Functional assessment following intrathecal baclofen therapy in children with spastic cerebral palsy.
The purpose of this article is to describe outcomes of intrathecal baclofen therapy for 29 patients with cerebral palsy, focusing on impairments, functional limitations, and disability. Patients received individualized rehabilitation and were followed up to 24 months. The primary outcome measures were the Ashworth Scale and the functional skills and caregiver assistance scales of the Pediatric Evaluation of Disability Inventory (PEDI). Ashworth Scale scores were significantly reduced (P < or = .0005). All areas of functional skills and caregiver assistance improved. Comparing groups of adults and patients less than 18 years, there were no significant differences, but there was a relationship between age and dose. Comparing groups of patients in high and low levels of independent functional mobility, no significant differences were found. These results provide suggestive evidence that the combination of intrathecal baclofen therapy and rehabilitation has positive effects across the dimensions of disablement. This study serves as a basis for high-level scientific studies of these effects.
Awaad
Yasser
Y
Neurology Division, Movement Disorder Clinic, Children's Hospital of Michigan, Wayne State University, School of Medicine, Detroit, MI, USA. awaady@oakwood.org
Tayem
Hassan
H
Munoz
Sharon
S
Ham
Steven
S
Michon
Anne Marie
AM
Awaad
Rania
R
D000203:Activities of Daily Living / Q000145:classification*; D000293:Adolescent; D000328:Adult; D001418:Baclofen / Q000008:administration & dosage* / Q000009:adverse effects; D002547:Cerebral Palsy / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D009128:Muscle Spasticity / Q000188:drug therapy; D009460:Neurologic Examination / Q000187:drug effects*; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities
D001418:Baclofen