title: Long-term therapy with intrathecal baclofen improves quality of life in children with severe spastic cerebral palsy.
abstract: BACKGROUND
  Children with severe spastic cerebral palsy (CP) are highly limited in daily life activities causing a reduced quality of life (QoL). This is partly due to an increased muscle tone causing pain and contractures. Continuous intrathecal infusion of baclofen (ITB) reduces the spasticity of affected patients. The hypothesis of the present study was that ITB leads to a significant improvement of QoL in non-ambulant children with CP.
  
  
  METHODS
  13 patients (10 male, 3 female, mean age 14 years) were included. Mean time between pump implantation and follow-up was 60 months (range, 12-100). QoL was assessed before and after baclofen pump implantation using standardized questionnaires (CP CHILD, KINDL). Spasticity was evaluated using the modified Ashworth Scale (MAS) at the two time points.
  
  
  RESULTS
  QoL evaluated with the CPCHILD questionnaire and the KINDL improved from pre - implantation to follow-up. MAS markedly decreased from 3.8 to 1.7. All interviewed participants indicated that their expectations had been met and that they would choose ITB treatment again.
  
  
  CONCLUSIONS
  Intrathecal treatment of baclofen is an excellent method for spasticity management in children with severe cerebral palsy. Quality of life sustainably improves, parents' satisfaction is high and the level of spasticity decreases. Therefore, baclofen treatment can be highly recommended in non-ambulant children with CP suffering from spasticity.
authors.affiliation: Division of Paediatric and Adolescent Orthopaedics, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria. Electronic address: tanja.kraus@medunigraz.at.
authors.forename: Tanja
authors.initials: T
authors.lastname: Kraus
authors.affiliation: Division of Paediatric and Adolescent Orthopaedics, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Gegenleitner
authors.affiliation: Division of Paediatric and Adolescent Orthopaedics, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Svehlik
authors.affiliation: Division of Paediatric and Adolescent Orthopaedics, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Novak
authors.affiliation: Division of Paediatric and Adolescent Orthopaedics, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
authors.forename: Gerhardt
authors.initials: G
authors.lastname: Steinwender
authors.affiliation: Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Singer
mesh_terms: D000293:Adolescent; D001418:Baclofen / Q000008:administration & dosage / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000150:complications / Q000188:drug therapy*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen
keywords: Cerebral palsy; Child; Intrathecal baclofen; Spasticity