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Oral baclofen in children with cerebral palsy: a double-blind cross-over pilot study
Adam Scheinberg1, Kate Hall, Lawrence T Lam
1Department of Rehabilitation, Centre for Trauma Care, Prevention, Education, and Research, The Royal Alexandra Hospital for Children, Sydney, Australia. adams2@chw.edu.au
Insights
Oral baclofen improved goal-oriented tasks in children with cerebral palsy (CP). This pilot study found baclofen more effective than placebo for functional improvements in pediatric CP patients.
Area of Science:
- Pediatric neurology
- Rehabilitation medicine
- Pharmacology
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder affecting motor function.
- Spasticity is a hallmark symptom of CP, impacting functional abilities.
- Oral baclofen is a muscle relaxant used to manage spasticity.
Purpose of the Study:
- To evaluate the efficacy of oral baclofen in reducing spasticity.
- To assess functional improvements in children with cerebral palsy (CP) using oral baclofen.
- To compare oral baclofen with placebo in a pediatric CP population.
Main Methods:
- Double-blind, randomized, cross-over pilot study design.
- Oral baclofen versus placebo administration.
- Utilized Goal Attainment Scale (GAS), Pediatric Evaluation of Disability Inventory (PEDI), Modified Tardieu Scale (MTS), and parent questionnaires for assessments.
Main Results:
- Fifteen children (mean age 7.4 years) with severe spastic quadriplegia (GMFCS IV-V) were included.
- Significant improvement observed in Goal Attainment Scale scores with baclofen compared to placebo (P=0.05).
- No significant differences found between baclofen and placebo for PEDI or MTS scores.
Conclusions:
- Oral baclofen demonstrated a statistically significant effect beyond placebo.
- Baclofen showed efficacy in improving goal-oriented functional tasks in children with spastic quadriplegic CP.
- Further research may explore baclofen's role in specific functional domains for pediatric CP.
Aim:
To assess the effectiveness of oral baclofen in reducing spasticity and improving function in children with cerebral palsy.
Methods:
A double-blind, randomised cross-over pilot study of oral baclofen versus placebo. Assessment tools included the Goal Attainment Scale, Pediatric Evaluation of Disability Inventory, Modified Tardieu Scale and parent questionnaire.
Results:
Fifteen children with mean age 7.4 years (SD=2.7 years) and spastic or spastic/dystonic quadriplegia (Gross Motor Function Classification System Level IV or V) were enrolled. Children scored significantly better on the Goal Attainment Scale with baclofen compared with placebo (F(1,13)=4.5, P=0.05). There was no significant difference between baclofen and placebo for the Pediatric Evaluation of Disability Inventory or Modified Tardieu Scale. Parent questionnaire results are described.
Conclusion:
This pilot study demonstrates that oral baclofen has an effect beyond placebo in improving goal-oriented tasks, such as transfers, in children with spastic quadriplegic cerebral palsy.
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