title: Intrathecal baclofen therapy for spastic hypertonia in chronic traumatic brain injury.
abstract: OBJECTIVE
  To describe the outcome of intrathecal baclofen (ITB) therapy in treating spastic hypertonia and its sequelae in individuals with chronic (>14 years) traumatic brain injuries (TBI).
  
  
  METHODS
  Case series.
  
  
  METHODS
  Free-standing rehabilitation hospital.
  
  
  METHODS
  Three adult males who received a TBI 14, 17.1, and 19.9 years prior to receiving ITB pump.
  
  
  METHODS
  Modified Ashworth Scale (MAS); Functional Independence Measure (FIM)-mobility scores; and informal functional evaluation.
  
  
  METHODS
  ITB therapy.
  
  
  RESULTS
  MAS scores of the five most hypertonic muscles in the affected lower limbs improved following of ITB therapy. FIM-mobility scores did not change from baseline, but certain functional domains improved, such as gait, transfers, and sitting; decreased assistance for activities of daily living (ADL) and nursing care; decreased painful spasms; and increased community mobility and participation in recreational activities.
  
  
  CONCLUSIONS
  ITB therapy is still beneficial even >14 years after TBI onset. In spite of the absence of improvement in FIM scores, functional enhancements in areas not measured by traditional scales can still be achieved. This suggests that in this patient population consideration for ITB therapy should not be based solely on conventional assessment scales.
authors: Physical Medicine and Rehabilitation Alliance, Baylor College of Medicine and University of Texas Health Sciences Center, Houston, USA. gerard.e.francisco@uth.tmc.edu
authors: Gerard E
authors: GE
authors: Francisco
authors: Juan M
authors: JM
authors: Latorre
authors: Cindy B
authors: CB
authors: Ivanhoe
mesh_terms: D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D020208:Brain Injury, Chronic / Q000150:complications*; D006801:Humans; D015918:Infusion Pumps, Implantable; D007263:Infusions, Parenteral; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen