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Upper limb function after intrathecal baclofen treatment in children with cerebral palsy
Francesco Motta1, Cecilia Stignani, Clara E Antonello
1Department of Paediatric Orthopaedics, V Buzzi Children's Hospital, Milan, Italy. f.motta@icp.mi.it
Insights
Intrathecal baclofen (ITB) therapy significantly improved upper limb motor function and reduced spasticity in children with cerebral palsy (CP). Patients experienced enhanced movement quality and satisfaction with ITB treatment outcomes.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Intrathecal baclofen (ITB) is known to reduce spasticity in cerebral palsy (CP).
- Evaluating upper limb motor function is crucial for assessing treatment efficacy in CP patients.
Purpose of the Study:
- To assess the impact of ITB treatment on upper limb motor function in patients with CP.
- To quantify improvements in motor skills and spasticity following ITB therapy.
Main Methods:
- A cohort of 20 patients with spastic CP (mean age 11.4 years) received ITB therapy.
- Patients were classified using the Gross Motor Function Classification System.
- Upper limb function was evaluated over 12 months using the Melbourne Assessment of Unilateral Upper Limb Function scale.
Main Results:
- All 20 patients demonstrated a reduction in upper limb spasticity (P < 0.05).
- Statistically significant improvements were observed in the total Melbourne scale score, range of movement, target accuracy, and fluency (P < 0.05).
- Twenty-five percent of patients achieved clinically significant functional improvements.
Conclusions:
- ITB therapy led to improved upper limb function quality in CP patients across various severity levels.
- Patients reported overall satisfaction with the functional outcomes of ITB treatment.
- The study highlights the importance of assessing upper limb function quality in CP patients undergoing ITB therapy.
Background:
The literature shows that intrathecal baclofen (ITB) treatment in patients with cerebral palsy (CP) is able to reduce spasticity. The purpose of this work is to evaluate the motor function of the upper limbs in patients with CP treated with ITB.
Methods:
A consecutive series of 20 patients with spastic CP (mean age at implant, 11.4 years) implanted with pumps in our center was studied. These patients were classified using the Gross Motor Function Classification System. The patients were followed up over a 12-month period for assessment of the upper limb function with the Melbourne Assessment of Unilateral Upper Limb Function scale.
Results:
The data show a reduction of upper limb spasticity in all 20 patients (P < 0.05). The Melbourne scale shows a statistically significant improvement of the total score (P < 0.05) and an improvement of the subskills of range of movement, target accuracy, and fluency. Twenty-five percent of patients showed a clinically significant improvement.
Conclusion:
The subjects with CP of different degrees of severity had an improvement in the quality of the upper limb function and showed overall satisfaction with the results achieved. The study also shows the importance of evaluating the quality of upper limb function in children with CP treated with ITB therapy.
