Hip status in cerebral palsy after one year of continuous intrathecal baclofen infusion.
The purpose of this study was to assess whether reduction of muscle tone by continuous intrathecal baclofen infusion affects the progression of hip subluxation in persons with cerebral palsy. This prospective, open-label, case series was conducted at multiple specialty referral centers. There were 33 subjects, ages 4 to 31 years. All had a pretreatment lower extremity Ashworth score of >/=3; all subjects had a significant reduction in tone after a bolus injection of intrathecal baclofen and received an implanted pump for continuous delivery of intrathecal baclofen. Subjects had hip x-rays before and 1 year after pump implantation. The primary outcome measure was change in absolute hip migration percentage. One third of the hips had an increase of absolute migration percentage of 5% or more; 12% of the hips had a decrease of migration percentage of 5% or more. Change of migration percentage class was used as a second outcome criterion. 90.9% of hips manifested no deterioration or had improvement of their migration percentage class during the year of intrathecal baclofen therapy. The observed changes were not associated with the subject's age or the severity of cerebral palsy.
Krach
Linda E
LE
Pediatric Rehabilitation Medicine at Gillette Children's Specialty Healthcare, St. Paul, Minnesota, USA.
Kriel
Robert L
RL
Gilmartin
Richard C
RC
Swift
Dale M
DM
Storrs
Bruce B
BB
Abbott
Rick
R
Ward
John D
JD
Bloom
Karen K
KK
Brooks
William H
WH
Madsen
Joseph R
JR
McLaughlin
John F
JF
Nadell
Joseph M
JM
D000293:Adolescent; D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D002547:Cerebral Palsy / Q000145:classification / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000145:classification / Q000188:drug therapy*; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008124:Locomotion / Q000187:drug effects; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009129:Muscle Tonus / Q000187:drug effects; D011446:Prospective Studies; D016896:Treatment Outcome
D009125:Muscle Relaxants, Central; D001418:Baclofen