Article

The aim of this retrospective analysis was to determine the impact of
intrathecal baclofen (ITB) therapy on motor function in patients with cerebral
palsy (CP). METHOD: We studied 37 patients (18 males, 19 females) with CP treated
with ITB (mean age at implant 13 y 7 mo, SD 7 y). Eighteen patients were affected
by spastic diplegia, 12 by spastic quadriplegia, six by dystonic quadriplegia,
and one by hemidystonia. Nine participants were in Gross Motor Function
Classification System (GMFCS) level II, 13 in level III, seven in level IV, and
eight in level V. Motor function was assessed by the Gross Motor Function Measure
(GMFM) before the treatment and 12 months after the implant. RESULTS: The
collected data showed an increase in the total median GMFM score in the overall
population (p<0.001) and in every GMFM dimension (p<0.05) except for dimension D
(standing). The analysis by degree of impairment revealed that patients with
severe impairment and those with mild to moderate impairment improved the total
median GMFM score (p<0.001 and p<0.05 respectively). Analysis by age showed that
the best improvements in GMFM scores were reached by patients younger than 18
years old (p<0.05). Spasticity and dystonia, assessed by means of the Ashworth
and Barry-Albright Dystonia scales, significantly decreased 12 months after the
implant (p<0.001 and p<0.05 respectively). Finally, a subjective questionnaire
administered to patients/caregivers revealed an overall improvement in
participants' functional abilities. INTERPRETATION: The results suggest that ITB
therapy is an effective treatment for managing spasticity and dystonia, and for
improving motor function in children with CP.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith
Press.

Langue : ANGLAIS