title: Improvement in walking speed in poststroke spastic hemiplegia after intrathecal baclofen therapy: a preliminary study.
abstract: 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.
authors.affiliation: Physical Medicine and Rehabilitation Alliance, Baylor College of Medicine and University of Texas-Houston Medical School, Houston, TX, USA. francg@tirr.tmc.edu
authors.forename: Gerard E
authors.initials: GE
authors.lastname: Francisco
authors.forename: Corwin
authors.initials: C
authors.lastname: Boake
mesh_terms: 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
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen