GMFM 1 year after continuous intrathecal baclofen infusion.
The purpose of this study was to assess whether there is an improvement in motor function in persons with cerebral palsy (CP) who have had a reduction of muscle tone by continuous intrathecal baclofen infusion. This was a prospective, open label, non-blinded case series without a control group, conducted at multiple centres. There were 31 subjects, aged 4-29 years. All had a pre-treatment mean lower extremity Ashworth scores of >or= 3 and a significant reduction in tone after a bolus injection of intrathecal baclofen (ITB) and received an implanted pump for continuous delivery of ITB. Motor function was assessed by the Gross Motor Function Measure (GMFM) prior to and 1 year following pump implantation. Significant improvement (p < 0.05) in mean GMFM scores was seen in subjects < 8 years (mean change 4.1) and in those from 8-18 years (mean change 3.7) and in subjects with CP Classes 2 and 5 (mean changes 6.2 and 2.9). There was a statistically significant decrease (p < 0.05) in Ashworth scores in CP classes 2-5. Subjects or their caregivers that completed a survey about perceived changes stated that motor control, positioning and endurance improved.
Krach
Linda E
LE
Pediatric Rehabilitation Medicine at Gillette Children's Specialty Healthcare, St Paul, MN, USA. lkrach@gillettechildrens.com
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 / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000503:physiopathology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D035002:Lower Extremity / Q000503:physiopathology; D009043:Motor Activity / Q000187:drug effects* / Q000502:physiology; D009119:Muscle Contraction / Q000187:drug effects / Q000502:physiology; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000503:physiopathology / Q000517:prevention & control; D017060:Patient Satisfaction; D010807:Physical Endurance / Q000502:physiology; D011187:Posture / Q000502:physiology; D011446:Prospective Studies
D009125:Muscle Relaxants, Central; D001418:Baclofen