title: GMFM 1 year after continuous intrathecal baclofen infusion.
abstract: 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.
authors.affiliation: Pediatric Rehabilitation Medicine at Gillette Children's Specialty Healthcare, St Paul, MN, USA. lkrach@gillettechildrens.com
authors.forename: Linda E
authors.initials: LE
authors.lastname: Krach
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kriel
authors.forename: Richard C
authors.initials: RC
authors.lastname: Gilmartin
authors.forename: Dale M
authors.initials: DM
authors.lastname: Swift
authors.forename: Bruce B
authors.initials: BB
authors.lastname: Storrs
authors.forename: Rick
authors.initials: R
authors.lastname: Abbott
authors.forename: John D
authors.initials: JD
authors.lastname: Ward
authors.forename: Karen K
authors.initials: KK
authors.lastname: Bloom
authors.forename: William H
authors.initials: WH
authors.lastname: Brooks
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Madsen
authors.forename: John F
authors.initials: JF
authors.lastname: McLaughlin
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Nadell
mesh_terms: 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
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen