title: The outcome of intrathecal baclofen treatment on spastic diplegia: Preliminary results with a minimum of two year follow-up.
abstract: The purpose of this study is to report the short-term outcome of intrathecal baclofen therapy on the function of individuals with diplegic cerebral palsy (CP) and the health-related quality of life (HRQL) of their caregivers. Eight pediatric patients with spastic diplegia were treated with ITB following failed oral spasticity management and were followed for a minimum of 2 years. Physical and functional outcomes were assessed using Ashworth Scores (AS), Physician Rating Scale (PRS), and a subset of the Functional Independence Measure for children (WeeFIM). HRQL was assessed using SF-36, CES-D short form, Impact on Family Scale, Life Orientation Test, Rand Social Support Scale, and Social Desirability Scale. At final follow-up, AS was significantly reduced (all p ⩽ 0.03). The PRS scale showed statistically significant improvement in four out of six subscales: median gait pattern (p = 0.05), median hind foot strike (p = 0.03), median knee position (p = 0.03) and median hind foot gait (p = 0.05). The WeeFIM score improved significantly with a mean increase of 32% (p = 0.03). ITB therapy significantly reduced spasticity and improved the function of these eight children with diplegic CP. HRQL of the parents or the caregivers remained stable despite the surgical intervention and follow-up visits required for pump refills.
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Shilt
authors.forename: Susan
authors.initials: S
authors.lastname: Reeves
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Lai
authors.forename: Jeremy
authors.initials: J
authors.lastname: Wetter
authors.forename: Michael N
authors.initials: MN
authors.lastname: Cabrera
authors.forename: Kat
authors.initials: K
authors.lastname: Kolaski
authors.forename: Beth P
authors.initials: BP
authors.lastname: Smith