PHYSIOTHERAPEUTIC POTENTIAL BEFORE AND AFTER IMPLANTATION OF INTRATHECAL BACLOFEN INFUSION PUMP FOR TREATING SPASTICITY IN CHILD WITH CEREBRAL PALSY

Abstract

Purpose: To monitor and analyze physiotherapeutic potential before and after implantation of an intrathecal baclofen infusion pump for treating spasticity in a child with cerebral palsy. Material: We present a 6-year-old girl with a massive spastic dystonic motor disorder, after hypoxic brain damage, based on an aspiration event in 2017. The first 6 months after the accident, the child is in a coma, 8 months in a state of awake coma. He has been conscious since the beginning of 2019. The diagnosis is bilateral spastic-dyskinetic paralysis, structural epilepsy, suspected cerebral blindness, subluxation of the hip joints bilaterally. For the period from coma to now, the child has received the following treatment: gastrostomy, replacement with Button, application of ventriculo-peritenoic shunt, botulinum toxin therapy, implantation of intrathecal baclofen infusion pump for treating spasticity. From the third month after the accident until now, physiotherapy is performed 3-4 times a week, monitoring the condition and changes in the functional capabilities of the child. Results: Before the baclofen pump, physiotherapy is mostly preventive against contractures and ankylosis. The child's functional capabilities and learning in motor activities are severely limited by central spasticity. 6 months after the placement of the baclofen pump, muscle tone decreased, and the child's physiotherapeutic potential increased. Conclusions: The physiotherapeutic potential is significantly increased after implantation of an intrathecal baclofen infusion pump, as muscle tone is significantly reduced.