Oral motor, communication, and nutritional status of children during intrathecal baclofen therapy: a descriptive pilot study.
OBJECTIVE
To describe the oral motor, communication, and nutritional status of children receiving intrathecal baclofen (ITB) therapy for spasticity of cerebral origin.


METHODS
Observational cross-sectional design.


METHODS
Tertiary-care regional children's hospital.


METHODS
Thirty children with spasticity of cerebral origin receiving ITB therapy.


METHODS
Not applicable.


METHODS
One interviewer administered a structured in-person interview tool designed for this pilot study, data from which were collapsed into 4 change categories: communication and speech, feeding and nutrition, oral motor function, and gastrointestinal function. Functional severity was ranked with the Gross Motor Function Classification System (GMFCS).


RESULTS
Speech: 10 improved (5 in GMFCS level V) and 2 worsened. Use of assistive technology to communicate: 6 improved (5 in GMFCS level V). Appetite: 10 improved (6 in GMFCS level V) and 4 worsened. Self-feeding: 9 improved (2 in GMFCS level III, 4 in level IV, 3 in level V) and 2 worsened. Saliva control: 10 improved (1 in GMFCS level III, 1 in level IV, 8 in level V) and 8 worsened. Cup drinking: 12 improved (5 in GMFCS level V) and 2 worsened. Indicates thirst: 9 improved (4 in GMFCS level IV, 5 in level V) and none worsened. Stool frequency: 8 improved (8 in GMFCS level V) and 14 worsened.


CONCLUSIONS
Some aspects of speech, communication, and saliva control seemed to have improved, with bowel movement frequency decreased in some children receiving ITB. Fewer changes in feeding and nutritional status were reported. On the basis of this pilot study, prospective management guidelines are proposed that relate objective outcome measures of oral motor function, communication, and nutrition to changes in spasticity with ITB.
Bjornson
Kristie F
KF
Children's Hospital and Regional Medical Center, Neurodevelopmental Clinic, Spasticity Management Clinic, Seattle, WA, USA. kristie.bjornson@seattlechildrens.org
McLaughlin
John F
JF
Loeser
John D
JD
Nowak-Cooperman
Kim M
KM
Russel
Mark
M
Bader
Kathy A
KA
Desmond
StarRina A
SA
D000293:Adolescent; D000328:Adult; D001418:Baclofen / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy*; D002648:Child; D003142:Communication; D003430:Cross-Sectional Studies; D019988:Children with Disabilities / Q000534:rehabilitation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal / Q000379:methods; D007322:Instillation, Drug; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D009125:Muscle Relaxants, Central / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D009752:Nutritional Status; D010865:Pilot Projects; D013060:Speech; D011795:Surveys and Questionnaires
D009125:Muscle Relaxants, Central; D001418:Baclofen