title: Intrathecal baclofen and motor function in cerebral palsy.
abstract: OBJECTIVE
  The aim of this retrospective analysis was to determine the impact of intrathecal baclofen (ITB) therapy on motor function in patients with cerebral palsy (CP).
  
  
  METHODS
  We studied 37 patients (18 males, 19 females) with CP treated with ITB (mean age at implant 13 y 7 mo, SD 7 y). Eighteen patients were affected by spastic diplegia, 12 by spastic quadriplegia, six by dystonic quadriplegia, and one by hemidystonia. Nine participants were in Gross Motor Function Classification System (GMFCS) level II, 13 in level III, seven in level IV, and eight in level V. Motor function was assessed by the Gross Motor Function Measure (GMFM) before the treatment and 12 months after the implant.
  
  
  RESULTS
  The collected data showed an increase in the total median GMFM score in the overall population (p<0.001) and in every GMFM dimension (p<0.05) except for dimension D (standing). The analysis by degree of impairment revealed that patients with severe impairment and those with mild to moderate impairment improved the total median GMFM score (p<0.001 and p<0.05 respectively). Analysis by age showed that the best improvements in GMFM scores were reached by patients younger than 18 years old (p<0.05). Spasticity and dystonia, assessed by means of the Ashworth and Barry-Albright Dystonia scales, significantly decreased 12 months after the implant (p<0.001 and p<0.05 respectively). Finally, a subjective questionnaire administered to patients/caregivers revealed an overall improvement in participants' functional abilities.
  
  
  CONCLUSIONS
  The results suggest that ITB therapy is an effective treatment for managing spasticity and dystonia, and for improving motor function in children with CP.
authors.affiliation: Department of Paediatric Orthopaedics, V. Buzzi Children's Hospital, Milan, Italy. f.motta@icp.mi.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Motta
authors.forename: Clara E
authors.initials: CE
authors.lastname: Antonello
authors.forename: Cecilia
authors.initials: C
authors.lastname: Stignani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001418:Baclofen / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000145:classification / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D058786:GABA-B Receptor Agonists / Q000627:therapeutic use*; D006801:Humans; D007278:Injections, Spinal / Q000379:methods; D008297:Male; D009069:Movement Disorders / Q000188:drug therapy* / Q000209:etiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D058786:GABA-B Receptor Agonists; D001418:Baclofen