Functional Assessment Following Intrathecal Baclofen Therapy in Children With Spastic Cerebral Palsy

Author:

Awaad Yasser1,Tayem Hassan2,Munoz Sharon2,Ham Steven2,Michon Anne Marie2,Awaad Rania2

Affiliation:

1. Neurology Division Movement Disorder Clinic, Children's Hospital of Michigan, Wayne State University, School of Medicine, Detroit, MI,

2. Neurology Division Movement Disorder Clinic, Children's Hospital of Michigan, Wayne State University, School of Medicine, Detroit, MI

Abstract

The purpose of this article is to describe outcomes of intrathecal baclofen therapy for 29 patients with cerebral palsy, focusing on impairments, functional limitations, and disability. Patients received individualized rehabilitation and were followed up to 24 months. The primary outcome measures were the Ashworth Scale and the functional skills and caregiver assistance scales of the Pediatric Evaluation of Disability Inventory (PEDI). Ashworth Scale scores were significantly reduced ( P .0005). All areas of functional skills and caregiver assistance improved. Comparing groups of adults and patients less than 18 years, there were no significant differences, but there was a relationship between age and dose. Comparing groups of patients in high and low levels of independent functional mobility, no significant differences were found. These results provide suggestive evidence that the combination of intrathecal baclofen therapy and rehabilitation has positive effects across the dimensions of disablement. This study serves as a basis for high-level scientific studies of these effects. ( J Child Neurol 2003; 18: 26—34).

Publisher

SAGE Publications

Subject

Clinical Neurology,Pediatrics, Perinatology, and Child Health

Reference15 articles.

1. Intrathecal baclofen down-regulates GABAB receptors in the rat substantia gelatinosa

2. National Advisory Board: Research Plan for the National Center for Medical Rehabilitation Research . NIH Publication 93-3509. US Department of Health and Human Services, Washington, DC, 1993.

3. What does the Ashworth scale really measure and are instrumented measures more valid and precise?

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