Intrathecal baclofen in the management of post-stroke hypertonia: current applications and future directions.
This chapter will review the application of intrathecal baclofen (ITB) in the management of post-stroke hypertonia, a major complication that results in deformity and discomfort, and limits mobility and performance of activities of daily living (ADL). Initially, ITB was considered only in conditions characterized by severe multi-limb spastic hypertonia in non-ambulatory individuals. Lately, ITB is used in persons with stroke who can ambulate, with the intent of further improving walking ability. Early clinical experience and evidence suggest that when used in the appropriate patient, ITB is efficacious and safe in managing post-stroke hypertonia in individuals of various functional levels. This chapter will also review clinical situations that are common in the stroke population, which may influence treatment decision choices. There are still ample opportunities to conduct research on this treatment modality, especially in the areas of patient selection and outcomes in the stroke population.
Francisco
G E
GE
The Institute for Rehabilitation and Research, Houston, Texas 77030, USA. Gerard.E.Francisco@uth.tmc.edu
D001418:Baclofen / Q000627:therapeutic use*; D006801:Humans; D007278:Injections, Spinal; D009122:Muscle Hypertonia / Q000188:drug therapy* / Q000209:etiology*; D009125:Muscle Relaxants, Central / Q000627:therapeutic use*; D020521:Stroke / Q000150:complications*
D009125:Muscle Relaxants, Central; D001418:Baclofen