Intrathecal baclofen infusion for ambulant children with cerebral palsy.
This study assessed the effects of continuous intrathecal infusion of baclofen on the gait of ambulant children with cerebral palsy. Details, collected retrospectively before and after pump implantation, included Gillette Functional Assessment Questionnaire score, use of walking aids, Ashworth Scale score, and joint angle at which the stretch reflex was triggered. Twenty-one ambulant children and young adults with cerebral palsy were included. Their mean age was 11 years and 10 months (standard deviation, 4 years and 10 months; range, 6-22 years). The mean length of treatment was 25.8 months (range, 5-75 months). After treatment, the lower-limb Ashworth score decreased by 1.4 points (standard deviation, 0.52), and the Gillette Functional Assessment Questionnaire score increased significantly, from 5.04 (standard deviation, 2.08) to 6.09 (standard deviation, 2.05) (P < 0.05). Seven children were able to use less supportive walking aids. Continuous intrathecal baclofen infusion appears to decrease spasticity and improve the gait capacity of children with cerebral palsy. Prospective, controlled studies are necessary to prove the functional effect of intrathecal baclofen infusion.
Brochard
Sylvain
S
Department of Physical Medicine and Rehabilitation, Centre Hospitalo-Universitaire Morvan, Brest, France. sylvain.brochard@chu-brest.fr
Remy-Neris
Olivier
O
Filipetti
Paul
P
Bussel
Bernard
B
D001418:Baclofen / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000188:drug therapy* / Q000523:psychology; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000187:drug effects / Q000502:physiology; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000188:drug therapy; D011187:Posture / Q000502:physiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D009125:Muscle Relaxants, Central; D001418:Baclofen