title: Prospective 12-month study of intrathecal baclofen therapy for poststroke spastic upper and lower extremity motor control and functional improvement.
abstract: OBJECTIVE
  To assess the effects of intrathecal baclofen (ITB) therapy for the treatment of poststroke spastic hemiparesis on quality of life, functional independence, and upper, lower extremity (UE, LE) motor functions.
  
  
  METHODS
  Prospective observational study of adult men and women with a minimum 6-month stroke-related spastic hemiparesis graded as ≥2 in UE and LE on Modified Ashworth Scale (MAS). Patients served as their own controls with measures compared pre-implant with 12 months post ITB including: MAS, manual muscle test (MMT), gait distance/velocity, Functional Independence Measures (FIM), stroke-specific quality of life scale (SSQL), and upper extremity manual activity log.
  
  
  RESULTS
  After 12-month ITB therapy, 26 patients (poststroke=6.4±9 years) demonstrated 1) reduced MAS/increased MMT for most LE muscle groups (p≤0.0001); 2) reduced MAS/increased MMT most UE muscle groups (p≤0.01); 3) FIM scores improved (p≤0.05) except bed mobility and lower body dressing; 4) gait distance and velocity improved (p≤0.05); 5) SSQL domains of family roles, mobility, personality, self-care, social roles, thinking, UE function, and work/productivity improved (p≤0.05); 6) amount of use and quality of movement of the spastic UE in performing common activities of daily living increased (p<0.0001).
  
  
  CONCLUSIONS
  Regardless of duration of spastic hemiparesis, a reduction in tone with ITB therapy facilitates motor strength improvement and is associated with clinically significant improvements in functional independence and quality of life.
authors: Department of Neurology, University of Texas Houston Medical School, Houston, TX 77030, USA. mya.c.schiess@uth.tmc.edu
authors: Mya C
authors: MC
authors: Schiess
authors: Irene J
authors: IJ
authors: Oh
authors: Erin F
authors: EF
authors: Stimming
authors: Joseph
authors: J
authors: Lucke
authors: Fernando
authors: F
authors: Acosta
authors: Stanley
authors: S
authors: Fisher
authors: Richard K
authors: RK
authors: Simpson
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001418:Baclofen / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D035002:Lower Extremity / Q000502:physiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000627:therapeutic use*; D053580:Muscle Strength; D009129:Muscle Tonus; D020336:Paraparesis, Spastic / Q000188:drug therapy* / Q000209:etiology* / Q000534:rehabilitation*; D011446:Prospective Studies; D012648:Self Care; D020521:Stroke / Q000150:complications* / Q000188:drug therapy*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000502:physiology / Q000503:physiopathology
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen