Improvement in walking speed in poststroke spastic hemiplegia after intrathecal baclofen therapy: a preliminary study.
OBJECTIVE
To explore whether intrathecal baclofen (ITB) therapy improves ambulation in stroke survivors.


METHODS
Case series.


METHODS
Tertiary care center.


METHODS
Ten adults with poststroke hemiparesis who were ambulatory at the time of pump implantation.


METHODS
Implantation of ITB pump after inadequate control of spasticity with other interventions. Time from stroke onset to implantation averaged 28.6 months (range, 9-55mo).


METHODS
Customary walking speed was measured from the time required to walk 50ft (15m) at a self-selected pace. Evaluators rated spastic hypertonia and functional mobility.


RESULTS
Statistically significant improvements occurred in walking speed, functional mobility ratings, and spasticity (P<.05) at a follow-up interval that averaged 8.9 months. Mean walking speed over 50ft improved from 36.6 to 52cm/s. Mean Modified Ashworth Scale scores in the muscles of the affected lower limb improved from 2.0 to 0.4. Normal muscle strength (5/5) was preserved in the unaffected limbs.


CONCLUSIONS
This preliminary study suggests that ITB therapy, in combination with physical therapy, may improve walking speed and functional mobility in ambulatory individuals with poststroke spastic hemiplegia.
Francisco
Gerard E
GE
Physical Medicine and Rehabilitation Alliance, Baylor College of Medicine and University of Texas-Houston Medical School, Houston, TX, USA. francg@tirr.tmc.edu
Boake
Corwin
C
D000328:Adult; D000368:Aged; D001418:Baclofen / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006429:Hemiplegia / Q000188:drug therapy* / Q000209:etiology / Q000534:rehabilitation; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal / Q000379:methods; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000008:administration & dosage* / Q000009:adverse effects; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology / Q000534:rehabilitation; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology
D009125:Muscle Relaxants, Central; D001418:Baclofen